Healthcare Provider Details
I. General information
NPI: 1295081065
Provider Name (Legal Business Name): FORREST PENDLETON ALLEN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/31/2012
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2011 MURPHY AVE STE 301
NASHVILLE TN
37203-2023
US
IV. Provider business mailing address
300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US
V. Phone/Fax
- Phone: 615-327-9543
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 3355 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 3355 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: