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General NPI Number Information
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NPI Number | 1740286921
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Entity Type | Individual
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Provider Name | WILLIAM R ALLEN MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 4071 TATES CREEK CENTRE DR SUITE 202
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City | LEXINGTON
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State | KY
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Zip | 40517-3062
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Country | US
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Telephone | 859-971-4695
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Fax | 859-971-4604
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Provider Business Mailing Address
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Address Line | 793 EASTERN BYP STE 101
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City | RICHMOND
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State | KY
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Zip | 40475-2422
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Country | US
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Telephone | 859-626-8645
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Fax | 859-626-8661
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 20000
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License Number State | KY
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