Provider Demographics
NPI:1407801210
Name:ALLEN, RICHARD BROWNING (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BROWNING
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14185
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-1185
Mailing Address - Country:US
Mailing Address - Phone:912-350-8436
Mailing Address - Fax:
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-8436
Practice Address - Fax:912-330-1104
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA700312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH300065459OtherRAILROAD MEDICARE
OH2006493Medicaid
OHF42332Medicare UPIN
OH0823473Medicare PIN
OH0823282Medicare PIN
OH0823281Medicare PIN
OHAL0823479Medicare ID - Type Unspecified
OH2006493Medicaid
OH0823474Medicare PIN