Provider Demographics
NPI:1629170485
Name:ALLEN, TERESA DORIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:DORIAN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7047 HALCYON PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7763
Mailing Address - Country:US
Mailing Address - Phone:334-273-0904
Mailing Address - Fax:334-273-0905
Practice Address - Street 1:7047 HALCYON PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7763
Practice Address - Country:US
Practice Address - Phone:334-273-0904
Practice Address - Fax:334-273-0905
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine