Healthcare Provider Details

I. General information

NPI: 1396431847
Provider Name (Legal Business Name): ALLANAH KING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 DOWELL AVE
BELLEFONTAINE OH
43311-2305
US

IV. Provider business mailing address

118 DOWELL AVE
BELLEFONTAINE OH
43311-2305
US

V. Phone/Fax

Practice location:
  • Phone: 937-593-5437
  • Fax: 937-593-0110
Mailing address:
  • Phone: 937-593-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.018652
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: