MEDICARE: DR. DAVID MORE ALLEN

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	174400000X	Specialist	53160261205	UT

General Provider Information

NPI Number	:	1487672986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MORE ALLEN

Provider Business Mailing Address
First Line	:	3860 JACKSON AVE
Second Line	:	STE 2
City	:	OGDEN
State	:	UT
Zip	:	84403-1997
Country	:	US
Telephone Number	:	801-627-0515
Fax Number	:	801-627-0517

Provider Business Practice Location Address
First Line	:	3860 JACKSON AVE STE 2
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84403-1979
Country	:	US
Telephone Number	:	801-627-0515
Fax Number	:	801-627-0517

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	05/11/2022

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Directions to “ DR. DAVID MORE ALLEN ” Practice Location

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