Provider Demographics
NPI:1841277241
Name:ALLISON, DAWN S (MD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:S
Last Name:ALLISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1510 SW NANCY WAY
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3215
Mailing Address - Country:US
Mailing Address - Phone:541-322-9000
Mailing Address - Fax:
Practice Address - Street 1:1208 BEALL LN
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-1573
Practice Address - Country:US
Practice Address - Phone:541-664-5151
Practice Address - Fax:541-664-5155
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD27692207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR117247Medicare PIN