Provider Demographics
NPI:1922064823
Name:ALLISON, EARL JACKSON JR (MD MPH)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:JACKSON
Last Name:ALLISON
Suffix:JR
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 TUNNEL ROAD
Mailing Address - Street 2:A 116
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2043
Mailing Address - Country:US
Mailing Address - Phone:828-299-5933
Mailing Address - Fax:828-299-2563
Practice Address - Street 1:1100 TUNNEL ROAD
Practice Address - Street 2:A 116
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2043
Practice Address - Country:US
Practice Address - Phone:828-299-5933
Practice Address - Fax:828-299-2563
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20089207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA9372385OtherDEA
D05657Medicare UPIN