Provider Demographics
NPI:1518080142
Name:ALLCOTT, DAVID AUSTIN (APRN)
Entity Type:Individual
Prefix:MS
First Name:DAVID
Middle Name:AUSTIN
Last Name:ALLCOTT
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Gender:M
Credentials:APRN
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Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:ATK LAUNCH SYSTEMS GROUP
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-0707
Mailing Address - Country:US
Mailing Address - Phone:435-863-2881
Mailing Address - Fax:435-863-2882
Practice Address - Street 1:9160 HWY 83 N
Practice Address - Street 2:BLDG M-35
Practice Address - City:CORRINE
Practice Address - State:UT
Practice Address - Zip Code:84302-0707
Practice Address - Country:US
Practice Address - Phone:435-863-2881
Practice Address - Fax:435-863-2882
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
UT361546-4405363LX0106X
UT361546-8900363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health