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General NPI Number Information
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NPI Number | 1104814797
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Entity Type | Individual
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Provider Name | MICHAEL GARY ALLISON D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/09/2005
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 421 SOUTH MAIN STREET
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City | CROSSVILLE
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State | TN
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Zip | 38555
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Country | US
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Telephone | 931-484-9511
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Fax | 931-456-4405
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Provider Business Mailing Address
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Address Line | 1307 WEST AVE SUITE 102
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City | CROSSVILLE
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State | TN
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Zip | 38555-5107
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Country | US
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Telephone | 931-456-4433
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Fax | 931-456-4405
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | OS-006810L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 18895
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 188099
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 6347
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 1974
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 188099
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License Number State | PA
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