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General NPI Number Information
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NPI Number | 1164477394
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Entity Type | Individual
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Provider Name | LAURA HALL ALLEN M.D,
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 107 W MEDICAL PARK DR SUITE 102
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City | LEXINGTON
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State | NC
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Zip | 27292-6851
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Country | US
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Telephone | 336-238-1679
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Fax | 336-713-6622
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Provider Business Mailing Address
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Address Line | PO BOX 24848
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City | WINSTON SALEM
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State | NC
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Zip | 27114-4848
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Country | US
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Telephone | 336-238-1679
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Fax | 336-713-6622
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 2010-00586
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License Number State | NC
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