Provider Demographics
NPI:1609860154
Name:SLOAN, ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:SLOAN
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 1:6336 N ORACLE RD STE 326
Mailing Address - Street 2:PMB302
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5457
Mailing Address - Country:US
Mailing Address - Phone:520-360-9880
Mailing Address - Fax:520-299-0376
Practice Address - Street 1:6336 N ORACLE RD STE 326
Practice Address - Street 2:PMB302
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5457
Practice Address - Country:US
Practice Address - Phone:520-360-9880
Practice Address - Fax:520-299-0376
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17481207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ05WCHGG35Medicare ID - Type Unspecified
AZC66510Medicare UPIN