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General NPI Number Information
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NPI Number | 1851838783
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Entity Type | Individual
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Provider Name | JEFFERY DUANE ALLEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 320 1ST ST NW
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City | WASHINGTON
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State | DC
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Zip | 20534-0002
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Country | US
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Telephone | 202-616-8371
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Fax |
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Provider Business Mailing Address
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Address Line | 203 HOLLYPORT RD
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City | HENRICO
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State | VA
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Zip | 23229-7620
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Country | US
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Telephone |
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Fax |
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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 | 0101054166
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License Number State | VA
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