Healthcare Provider Details

I. General information

NPI: 1508328121
Provider Name (Legal Business Name): ALLISON KATHERINE FALCON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 CLINIC AVE STE 302B
CARROLLTON GA
30117-4454
US

IV. Provider business mailing address

157 CLINIC AVE STE 302B
CARROLLTON GA
30117-4454
US

V. Phone/Fax

Practice location:
  • Phone: 770-812-5902
  • Fax: 770-812-5903
Mailing address:
  • Phone: 770-812-5902
  • Fax: 770-812-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number111822
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: