Healthcare Provider Details

I. General information

NPI: 1639398290
Provider Name (Legal Business Name): ALLISON DOOLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 MOUNTAIN CITY RD
CLAYTON GA
30525-3072
US

IV. Provider business mailing address

PO BOX 459
COLBERT GA
30628-0459
US

V. Phone/Fax

Practice location:
  • Phone: 706-521-3113
  • Fax:
Mailing address:
  • Phone: 706-788-3234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number98798
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: