Healthcare Provider Details

I. General information

NPI: 1164876991
Provider Name (Legal Business Name): JUSTIN ALEXANDER ALLARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N FORGE ST
AKRON OH
44304-1407
US

IV. Provider business mailing address

55 ARCH ST STE 2D
AKRON OH
44304-1424
US

V. Phone/Fax

Practice location:
  • Phone: 330-535-1536
  • Fax: 330-535-1539
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.145159
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number35.145159
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: