Provider Demographics
NPI:1669418067
Name:WHITMAN, ALISON DAWN (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:DAWN
Last Name:WHITMAN
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 1:999 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4632
Mailing Address - Country:US
Mailing Address - Phone:423-224-3250
Mailing Address - Fax:423-224-3258
Practice Address - Street 1:24530 FALCON PLACE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7657
Practice Address - Country:US
Practice Address - Phone:276-619-3801
Practice Address - Fax:276-619-3810
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40686207Q00000X
VA0101239325207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38212622Medicaid
TN1506538Medicaid
TN3700592Medicaid
VA1669418067Medicaid
VAMC11042Medicaid
TN3700592Medicare PIN
TN3700592Medicaid
TN38212622Medicaid
VAV V2150AMedicare PIN
VAMC11042Medicaid
TN103I086169Medicare UPIN
VAV V2150BMedicare PIN