Provider Demographics
NPI:1134792161
Name:SPRINGSTON, ALLISON JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JEAN
Last Name:SPRINGSTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WOODCOCK RD UNIT 3314
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-1093
Mailing Address - Country:US
Mailing Address - Phone:804-731-9132
Mailing Address - Fax:
Practice Address - Street 1:60 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-7644
Practice Address - Country:US
Practice Address - Phone:912-756-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10482363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant