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General NPI Number Information
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NPI Number | 1710942271
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Entity Type | Organization
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Legal Business Name | ALLEN EYE ASSOCIATES INC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 504 E ELIZABETH STREET SUITE 4
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4404
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Country | US
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Telephone | 252-384-0929
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Fax | 252-384-0916
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Provider Business Mailing Address
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Address Line | 504 E ELIZABETH STREET SUITE 4
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4404
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Country | US
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Telephone | 252-384-0929
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Fax | 252-384-0916
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN P ALLEN
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Credential | MD
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Telephone | 252-384-0929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2000300114
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License Number State | NC
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