Provider Demographics
NPI:1992909782
Name:SIKES, ALLISON RENEE (ABOC)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:RENEE
Last Name:SIKES
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICKAMAUGA
Mailing Address - State:GA
Mailing Address - Zip Code:30707-1275
Mailing Address - Country:US
Mailing Address - Phone:706-375-3456
Mailing Address - Fax:
Practice Address - Street 1:101 E LAFAYETTE SQ
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-2929
Practice Address - Country:US
Practice Address - Phone:706-638-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician