Provider Demographics
NPI:1639195977
Name:ALLEN, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6410 S KINGS RANCH RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-7352
Mailing Address - Country:US
Mailing Address - Phone:480-761-2500
Mailing Address - Fax:480-288-2879
Practice Address - Street 1:6410 S KINGS RANCH RD
Practice Address - Street 2:1
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85218-7352
Practice Address - Country:US
Practice Address - Phone:480-981-3000
Practice Address - Fax:480-654-5761
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ30153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ816712Medicaid
AZ119365Medicare PIN
AZ816712Medicaid