Provider Demographics
NPI:1245254085
Name:AKERS, ALICIA DAWN
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:DAWN
Last Name:AKERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 COUNTY ROAD 41 N
Mailing Address - Street 2:
Mailing Address - City:PEDRO
Mailing Address - State:OH
Mailing Address - Zip Code:45659-8502
Mailing Address - Country:US
Mailing Address - Phone:740-643-2258
Mailing Address - Fax:740-643-2293
Practice Address - Street 1:4280 COUNTY ROAD 41 N
Practice Address - Street 2:
Practice Address - City:PEDRO
Practice Address - State:OH
Practice Address - Zip Code:45659-8502
Practice Address - Country:US
Practice Address - Phone:740-643-2258
Practice Address - Fax:740-643-2293
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2395064363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2395064OtherOHIO IP