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General NPI Number Information
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NPI Number | 1013479468
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Entity Type | Individual
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Provider Name | ALLEN YEN MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 5665 PEACHTREE DUNWOODY RD
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City | ATLANTA
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State | GA
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Zip | 30342-1764
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Country | US
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Telephone | 404-778-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 OGLETHORPE DR NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-2781
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Country | US
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Telephone | 405-564-4427
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 100790
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License Number State | GA
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