Provider Demographics
NPI:1033229083
Name:ALLEN, NECHOL LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:NECHOL
Middle Name:LEIGH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-238-2801
Mailing Address - Fax:502-238-2835
Practice Address - Street 1:3950 KRESGE WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4637
Practice Address - Country:US
Practice Address - Phone:502-895-3633
Practice Address - Fax:502-895-3639
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP990208600000X
KY44533208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213220Medicaid
GA930162OtherBC/BS OF GA
P00429468OtherRR MEDICARE
OR213220Medicaid
P00429468OtherRR MEDICARE