Provider Demographics
NPI:1003295783
Name:ALLIED PHYSICIAN GROUP LLC
Entity Type:Organization
Organization Name:ALLIED PHYSICIAN GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-314-2552
Mailing Address - Street 1:2200 E PARRISH AVE
Mailing Address - Street 2:BUILDING A
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1449
Mailing Address - Country:US
Mailing Address - Phone:270-926-2273
Mailing Address - Fax:270-926-5200
Practice Address - Street 1:2200 E PARRISH AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1449
Practice Address - Country:US
Practice Address - Phone:270-926-2273
Practice Address - Fax:270-926-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200303261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service