MEDICARE: CARRIE GRACE 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	207Q00000X	Family Medicine Physician	33271	MS

General Provider Information

NPI Number	:	1255071288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE GRACE ALLEN MD

Provider Business Mailing Address
First Line	:	764 LAKELAND DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4651
Country	:	US
Telephone Number	:	601-984-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	764 LAKELAND DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4651
Country	:	US
Telephone Number	:	601-984-6800
Fax Number	:

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

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	05/25/2026

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Directions to “ CARRIE GRACE ALLEN MD” Practice Location

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