MEDICARE: LAWRENCE M ALLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	5650	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174596142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE M ALLEN MD

Provider Business Mailing Address
First Line	:	5915 S RAINBOW BLVD STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2558
Country	:	US
Telephone Number	:	702-366-0640
Fax Number	:	702-366-9075

Provider Business Practice Location Address
First Line	:	5915 S RAINBOW BLVD STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2558
Country	:	US
Telephone Number	:	702-366-0640
Fax Number	:	702-366-9075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	06/02/2022

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Directions to “ LAWRENCE M ALLEN MD” Practice Location

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