MEDICARE: CARL ALLEN 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
1	207V00000X	Obstetrics & Gynecology Physician	8384	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043284995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL ALLEN MD

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-579-3203
Fax Number	:	702-242-1535

Provider Business Practice Location Address
First Line	:	420 N NELLIS BLVD STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-5365
Country	:	US
Telephone Number	:	702-243-8500
Fax Number	:	702-242-1535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	05/23/2024

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