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General NPI Number Information
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NPI Number | 1063455541
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Entity Type | Individual
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Provider Name | JOHN CLIFFORD ALLEN M.S., D.A.A.E.T.S.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 11/26/2016
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Provider Practice Location Address
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Address Line | 5721 5TH CT S
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City | BIRMINGHAM
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State | AL
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Zip | 35212-3211
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Country | US
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Telephone | 205-567-0832
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 531166
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City | MOUNTAIN BROOK
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State | AL
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Zip | 35253-1166
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Country | US
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Telephone | 205-567-0832
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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 | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 5064
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-083260
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License Number State | AL
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