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General NPI Number Information
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NPI Number | 1255579009
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Entity Type | Organization
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Legal Business Name | ALLAHHAM CLINIC, PLLC
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 1000 E LEXINGTON AVE SUITE 25
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City | DANVILLE
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State | KY
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Zip | 40422-9042
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Country | US
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Telephone | 859-236-7756
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Fax | 859-236-7209
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Provider Business Mailing Address
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Address Line | PO BOX 23
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City | DANVILLE
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State | KY
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Zip | 40423-0023
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Country | US
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Telephone | 859-236-7756
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Fax | 859-236-7209
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN H. ALLAHHAM
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Credential | M.D.
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Telephone | 859-236-7756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 30090
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 30090
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License Number State | KY
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