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NPI Code Detail

MEDICARE: ALLISON SAGE WILSON MD

MEDICARE: ALLISON SAGE WILSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramOH

General Provider Information

NPI Number : 1275471955
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON SAGE WILSON MD
Provider Business Mailing Address
First Line : 1775 W LEXINGTON
Second Line : SUITE 100
City : CINCINNATI
State : OH
Zip : 45212-3589
Country : US
Telephone Number : 337-494-2023
Fax Number :
Provider Business Practice Location Address
First Line : 1775 W LEXINGTON
Second Line : SUITE 100
City : CINCINNATI
State : OH
Zip : 45212-3589
Country : US
Telephone Number : 337-494-2023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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