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General NPI Number Information
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NPI Number | 1033319686
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Entity Type | Individual
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Provider Name | KATTIE J ALLEN MD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 901 SE PLAZA AVE STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-5473
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Country | US
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Telephone | 479-876-8550
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Fax | 479-208-4266
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Provider Business Mailing Address
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Address Line | 1651 E STEARNS ST STE 110
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-6196
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Country | US
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Telephone | 479-876-8550
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Fax | 479-208-4266
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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 | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | E7618
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | E7618
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License Number State | AR
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