Provider Demographics
NPI:1598128902
Name:ALLEN, AUBREY BRIAN (DO)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:BRIAN
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 HILLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-6779
Mailing Address - Country:US
Mailing Address - Phone:601-674-6024
Mailing Address - Fax:
Practice Address - Street 1:1506 N MCKENZIE ST STE 107
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2264
Practice Address - Country:US
Practice Address - Phone:251-433-1895
Practice Address - Fax:251-433-1917
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
AL2557208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program