Healthcare Provider Details

I. General information

NPI: 1558330902
Provider Name (Legal Business Name): JAMES MADISON ALLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES M ALLEN MD

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 MONTGOMERY HWY
HOOVER AL
35216-4906
US

IV. Provider business mailing address

2147 RIVERCHASE OFFICE RD MSC 10000020
BIRMINGHAM AL
35244-1836
US

V. Phone/Fax

Practice location:
  • Phone: 205-979-0888
  • Fax: 205-979-4110
Mailing address:
  • Phone: 205-403-8902
  • Fax: 205-982-0278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9674
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: