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General NPI Number Information
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NPI Number | 1952545550
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Entity Type | Individual
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Provider Name | DR. JUSTIN RICHARD ALLEN
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Gender | Male
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 901 18TH ST E
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City | TIFTON
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State | GA
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Zip | 31794-3648
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Country | US
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Telephone | 229-353-6185
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 19TH ST
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3308
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Country | US
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Telephone | 917-324-9942
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 60266029
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | TPME761
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036155966
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD-23927
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License Number State | HI
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD-2526
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 47781
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License Number State | AL
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Taxonomy #7
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C159741
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 63785
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License Number State | AZ
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Taxonomy #9
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | E-17178
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License Number State | AR
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Taxonomy #10
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | CDR.0003441
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License Number State | CO
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Taxonomy #11
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 70770
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License Number State | CT
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Taxonomy #12
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | CI-0026630
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License Number State | DE
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Taxonomy #13
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD500002611
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License Number State | DC
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Taxonomy #14
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 213862
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License Number State | AK
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Taxonomy #15
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 70029
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License Number State | GA
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