Healthcare Provider Details

I. General information

NPI: 1952394710
Provider Name (Legal Business Name): ALLISON ANNE COGAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON ROBNETT

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 W TEMPLE AVE
EFFINGHAM IL
62401-2178
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 217-342-1234
  • Fax: 217-342-1230
Mailing address:
  • Phone: 702-877-8661
  • Fax: 710-266-7468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number10159
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036163894
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number10159
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: