Healthcare Provider Details

I. General information

NPI: 1508814922
Provider Name (Legal Business Name): STEVEN L ALLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3769 HWY 14
MILLBROOK AL
36054
US

IV. Provider business mailing address

2175 US HIGHWAY 31 N
DEATSVILLE AL
36022-2714
US

V. Phone/Fax

Practice location:
  • Phone: 334-285-3222
  • Fax: 334-285-6555
Mailing address:
  • Phone: 334-568-2120
  • Fax: 334-568-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00013124
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: