Provider Demographics
NPI:1952317794
Name:ALLISON, MARY ANN K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:K
Last Name:ALLISON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:400 N STEPHANIE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6692
Mailing Address - Country:US
Mailing Address - Phone:702-952-3350
Mailing Address - Fax:702-952-3365
Practice Address - Street 1:2460 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-822-2000
Practice Address - Fax:702-938-2237
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-05-29
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Provider Licenses
StateLicense IDTaxonomies
NV6754207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019486Medicaid
NVC12762Medicare UPIN
NV002019486Medicaid