Provider Demographics
NPI:1639163439
Name:DAVIS, ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:DAVIS
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 1:4 FARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5213
Mailing Address - Fax:860-284-5333
Practice Address - Street 1:105 NEWTOWN RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4114
Practice Address - Country:US
Practice Address - Phone:203-790-4511
Practice Address - Fax:203-790-4512
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041832207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine