Provider Demographics
NPI:1659374874
Name:ALLEN, ANTON M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:M
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2240 SUTHERLAND AVE
Mailing Address - Street 2:STE 107
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919
Mailing Address - Country:US
Mailing Address - Phone:865-584-7376
Mailing Address - Fax:865-584-3856
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-544-9060
Practice Address - Fax:865-544-8435
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2017-08-18
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Provider Licenses
StateLicense IDTaxonomies
TNMD255622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64925860Medicaid
TN3084180Medicaid
TN3084180Medicaid
TNE16339Medicare UPIN