Healthcare Provider Details

I. General information

NPI: 1568739381
Provider Name (Legal Business Name): ALLMON MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6534 FORD ST
BATON ROUGE LA
70811-4218
US

IV. Provider business mailing address

6534 FORD ST
BATON ROUGE LA
70811-4218
US

V. Phone/Fax

Practice location:
  • Phone: 225-354-0808
  • Fax: 225-354-0805
Mailing address:
  • Phone: 225-354-0808
  • Fax: 225-354-0805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. REUBEN V ALLMON
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 770-529-6801