Provider Demographics
NPI:1598701948
Name:ALLEN, GEORGE SEA III (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:SEA
Last Name:ALLEN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:230 LEXINGTON GREEN CIR STE 600
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3326
Mailing Address - Country:US
Mailing Address - Phone:859-971-4658
Mailing Address - Fax:859-971-4604
Practice Address - Street 1:1740 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1431
Practice Address - Country:US
Practice Address - Phone:859-260-6970
Practice Address - Fax:859-260-6649
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL27213207V00000X
KY23976207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100534690Medicaid
KYK202140OtherMEDICARE
AL529401030Medicaid