Healthcare Provider Details
I. General information
NPI: 1831651835
Provider Name (Legal Business Name): JOHN EVAN ALLISON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2019
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
236 ELM DR
WAYNESBURG PA
15370-8265
US
IV. Provider business mailing address
236 ELM DR
WAYNESBURG PA
15370-8265
US
V. Phone/Fax
- Phone: 724-627-0926
- Fax: 724-627-0812
- Phone: 724-627-0926
- Fax: 724-627-0812
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS022197 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: