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NPI Code Detail

MEDICARE: DR. LOREN BARRY ALLEN MD

MEDICARE: DR. LOREN BARRY 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
12080A0000XPediatric Adolescent Medicine PhysicianC4685AR

Other Identifiers

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

General Provider Information

NPI Number : 1811955974
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOREN BARRY ALLEN MD
Provider Business Mailing Address
First Line : 614 E EMMA AVE
Second Line : SUITE 300
City : SPRINGDALE
State : AR
Zip : 72764-4634
Country : US
Telephone Number : 479-751-7417
Fax Number : 479-751-4898
Provider Business Practice Location Address
First Line : 1223 W POPLAR ST
Second Line :
City : ROGERS
State : AR
Zip : 72756-4245
Country : US
Telephone Number : 479-636-9235
Fax Number : 479-631-0374
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 04/09/2020

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Directions to “ DR. LOREN BARRY ALLEN MD” Practice Location

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