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NPI Code Detail

MEDICARE: DR. JEFFERY B ALLEN PHD, ABPP-ABCN

MEDICARE: DR. JEFFERY B ALLEN PHD, ABPP-ABCN
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
1103G00000XClinical Neuropsychologist20043837AIN

General Provider Information

NPI Number : 1578564951
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFERY B ALLEN PHD, ABPP-ABCN
Provider Business Mailing Address
First Line : 2354 W BOULEVARD
Second Line :
City : KOKOMO
State : IN
Zip : 46902-6069
Country : US
Telephone Number : 765-457-4800
Fax Number :
Provider Business Practice Location Address
First Line : 2354 W BOULEVARD
Second Line :
City : KOKOMO
State : IN
Zip : 46902-6069
Country : US
Telephone Number : 765-457-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 01/30/2025

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