Healthcare Provider Details

I. General information

NPI: 1679727416
Provider Name (Legal Business Name): DESMOND PAUL ALLEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N 5TH ST
OPELIKA AL
36801-4106
US

IV. Provider business mailing address

406 N 5TH ST
OPELIKA AL
36801-4106
US

V. Phone/Fax

Practice location:
  • Phone: 334-745-2731
  • Fax: 334-745-2731
Mailing address:
  • Phone: 334-745-2731
  • Fax: 334-745-2731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2278G0305X
TaxonomyGeriatric Care Certified Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: