Healthcare Provider Details

I. General information

NPI: 1750907630
Provider Name (Legal Business Name): JOHN ALLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 HISTORIC DR
STRASBURG PA
17579-1479
US

IV. Provider business mailing address

505 HISTORIC DR
STRASBURG PA
17579-1479
US

V. Phone/Fax

Practice location:
  • Phone: 717-687-0313
  • Fax: 717-687-3604
Mailing address:
  • Phone: 717-687-0313
  • Fax: 717-687-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD480582
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: