MEDICARE: EVAN C 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	7132	NV

General Provider Information

NPI Number	:	1710980743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVAN C ALLEN MD

Provider Business Mailing Address
First Line	:	2510 WIGWAM PKWY STE 201
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7116
Country	:	US
Telephone Number	:	702-541-8240
Fax Number	:	702-541-8241

Provider Business Practice Location Address
First Line	:	2510 WIGWAM PKWY STE 201
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7116
Country	:	US
Telephone Number	:	702-541-8240
Fax Number	:	702-541-8241

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/03/2025

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Directions to “ EVAN C ALLEN MD” Practice Location

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