Provider Demographics
NPI:1861757676
Name:STERLING, ALLYSON HUDSON (DO)
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:HUDSON
Last Name:STERLING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ALLYSON
Other - Middle Name:SUZANNE
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:229 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ST MARIES
Mailing Address - State:ID
Mailing Address - Zip Code:83861-1803
Mailing Address - Country:US
Mailing Address - Phone:208-245-5551
Mailing Address - Fax:208-245-5246
Practice Address - Street 1:229 S 7TH ST FL 4
Practice Address - Street 2:
Practice Address - City:ST MARIES
Practice Address - State:ID
Practice Address - Zip Code:83861-1803
Practice Address - Country:US
Practice Address - Phone:208-245-7629
Practice Address - Fax:208-245-5246
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-1695208600000X
VA0102206117208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery