Healthcare Provider Details

I. General information

NPI: 1164047197
Provider Name (Legal Business Name): ALLISON M AKRIDGE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 HODGES DR
TALLAHASSEE FL
32308-4614
US

IV. Provider business mailing address

951 MATTHEW DR STE A
WAYNESBORO MS
39367-2566
US

V. Phone/Fax

Practice location:
  • Phone: 850-431-5430
  • Fax:
Mailing address:
  • Phone: 601-671-2825
  • Fax: 601-735-5205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number29405
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29405
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: