Healthcare Provider Details

I. General information

NPI: 1134331671
Provider Name (Legal Business Name): ARIELLE MARIE ALLEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 HEFNER POINTE DR STE B
OKLAHOMA CITY OK
73120-5049
US

IV. Provider business mailing address

11100 HEFNER POINTE DR STE B
OKLAHOMA CITY OK
73120-5049
US

V. Phone/Fax

Practice location:
  • Phone: 405-400-8188
  • Fax: 405-938-1008
Mailing address:
  • Phone: 405-400-8188
  • Fax: 405-938-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number4377
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: