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General NPI Number Information
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NPI Number | 1972122844
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Entity Type | Individual
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Provider Name | CAMERON C ALLEN PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1215 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3120
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Country | US
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Telephone | 928-773-2200
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Fax | 928-773-2300
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Provider Business Mailing Address
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Address Line | 1200 N BEAVER ST ATTN: PAYER CREDENTIALING
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-213-6235
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8247
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License Number State | AZ
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