Provider Demographics
NPI:1750376521
Name:ALLISON, JAMES RICHARD III (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:ALLISON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:201 SIGMA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7722
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:843-569-5879
Practice Address - Street 1:3700 FOREST DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4010
Practice Address - Country:US
Practice Address - Phone:803-799-1922
Practice Address - Fax:803-973-6626
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC8923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC110201591OtherRAILROAD MEDICARE
SC089237Medicaid
SC110201591OtherRAILROAD MEDICARE
SCD470489615Medicare PIN
D470485038Medicare PIN