Provider Demographics
NPI:1700121381
Name:PHILLIPS, ALISON L W (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:L W
Last Name:PHILLIPS
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 1:80 PEACHTREE RD
Mailing Address - Street 2:106
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3156
Mailing Address - Country:US
Mailing Address - Phone:828-232-5222
Mailing Address - Fax:
Practice Address - Street 1:80 PEACHTREE RD
Practice Address - Street 2:106
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3156
Practice Address - Country:US
Practice Address - Phone:828-232-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05747363AM0700X
TN2692363A00000X
FLPA 9106909363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant