Provider Demographics
NPI:1043213325
Name:ALLMON, BECKY LEIGH (DO)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:LEIGH
Last Name:ALLMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LEIGH
Other - Last Name:ALLMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2415 MITCHELL RD STE C
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-4747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2415 MITCHELL RD STE C
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4747
Practice Address - Country:US
Practice Address - Phone:812-277-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002493A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200389930Medicaid
INH77023Medicare UPIN
IN200389930AMedicaid
INH77023Medicare UPIN