Individual
JACQUELYN E ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
702 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5139
(317) 944-9981
(317) 944-0282
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01060687A
IN
207LP3000X
Pediatric Anesthesiology Physician
Primary
01060687A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200827410
—
IN
Enumeration date
06/01/2006
Last updated
11/19/2020
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