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NPI Code Detail

MEDICARE: STACY ALLEN PA-C

MEDICARE:   STACY  ALLEN  PA-C
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
1363A00000XPhysician Assistant50.007953RXOH

General Provider Information

NPI Number : 1548970247
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY ALLEN PA-C
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-8315
Fax Number : 614-293-6935
Provider Business Practice Location Address
First Line : 1145 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43212-3117
Country : US
Telephone Number : 614-293-8315
Fax Number : 614-293-6935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2022
Last Update Date : 01/26/2026

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Directions to “ STACY ALLEN PA-C” Practice Location

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