Healthcare Provider Details

I. General information

NPI: 1922091180
Provider Name (Legal Business Name): BARRY E ALLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8247 RIVER ROAD PIKE
NASHVILLE TN
37209
US

IV. Provider business mailing address

8247 RIVER ROAD PIKE
NASHVILLE TN
37209
US

V. Phone/Fax

Practice location:
  • Phone: 615-873-1237
  • Fax: 317-783-4107
Mailing address:
  • Phone: 615-873-1237
  • Fax: 317-783-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1053363
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01053363A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number01053363A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD0000025113
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: