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NPI 1275598278

NPI 1275598278 : BRIAN L ALLEN M.D. : GEORGETOWN, KY

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General NPI Number Information
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    NPI Number           |    1275598278
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN L ALLEN M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/20/2006
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    Last Update Date     |    02/01/2022
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Provider Practice Location Address
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    Address Line         |    202 BEVINS LN 
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    City                 |    GEORGETOWN
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    State                |    KY
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    Zip                  |    40324-6178
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    Country              |    US
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    Telephone            |    859-323-9333
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    Fax                  |    502-570-5322
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Provider Business Mailing Address
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    Address Line         |    202 BEVINS LN 
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    City                 |    GEORGETOWN
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    State                |    KY
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    Zip                  |    40324-6178
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    Country              |    US
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    Telephone            |    859-323-9333
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    Fax                  |    502-570-5322
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    39522
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    License Number State |    KY
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