Provider Demographics
NPI:1245644822
Name:THOMASSON, ALISON DEREMIGIS (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:DEREMIGIS
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD STE 6009B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8273
Mailing Address - Country:US
Mailing Address - Phone:314-251-6598
Mailing Address - Fax:314-251-7990
Practice Address - Street 1:621 S NEW BALLAS RD STE 6009B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8273
Practice Address - Country:US
Practice Address - Phone:314-251-6598
Practice Address - Fax:314-251-7990
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200201712080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine