Provider Demographics
NPI:1568838696
Name:ALLEN MEDICAL, PLLC
Entity Type:Organization
Organization Name:ALLEN MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RANDEL
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-942-3737
Mailing Address - Street 1:1226 N SHARTEL AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2421
Mailing Address - Country:US
Mailing Address - Phone:405-942-3737
Mailing Address - Fax:405-942-3873
Practice Address - Street 1:1226 N SHARTEL AVE
Practice Address - Street 2:STE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2421
Practice Address - Country:US
Practice Address - Phone:405-942-3737
Practice Address - Fax:405-942-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty