Provider Demographics
NPI:1669574554
Name:THRESHER, ALISON JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:JEAN
Last Name:THRESHER
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 1:1485 CORONA LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2508
Mailing Address - Country:US
Mailing Address - Phone:419-586-5170
Mailing Address - Fax:419-586-5177
Practice Address - Street 1:950 S MAIN ST
Practice Address - Street 2:SUITE #7
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-2479
Practice Address - Country:US
Practice Address - Phone:419-586-5170
Practice Address - Fax:419-586-5177
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3579289174400000X
WAMD61478175207V00000X
OH35079289207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2246028Medicaid
OH000000213061OtherBLUE CROSS BLUE SHIELD
OH000000213061OtherUNICARE
OHP00272253OtherRAILROAD MEDICARE
OH000000213061OtherBLUE CROSS BLUE SHIELD
OHP00272253OtherRAILROAD MEDICARE