Provider Demographics
NPI:1962513705
Name:ALLISON, JEFFERY SCOTT (MD)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:SCOTT
Last Name:ALLISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:930 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4312
Practice Address - Country:US
Practice Address - Phone:256-539-4080
Practice Address - Fax:256-539-4099
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24810207R00000X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102305Medicaid
AL112551Medicaid
AL009998235Medicaid
AL51598970OtherBCBS
7757751OtherAETNA
ALP00770862OtherRAILROAD MEDICARE
AL112583Medicaid
AL51049215OtherBCBS
AL51049214OtherBCBS
AL51049216OtherBCBS
AL51598971OtherBCBS
AL112555Medicaid
AL112565Medicaid
AL51547760OtherBCBS
AL112571Medicaid
AL51049217OtherBCBS
AL112578Medicaid
I32235Medicare UPIN
AL112565Medicaid
AL51049217OtherBCBS
AL51598971OtherBCBS
AL51049214OtherBCBS
AL051556165Medicare ID - Type Unspecified