Provider Demographics
NPI:1659530939
Name:ALLEN L ROHDE DPM
Entity Type:Organization
Organization Name:ALLEN L ROHDE DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROHDE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:405-329-3929
Mailing Address - Street 1:817 24TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6313
Mailing Address - Country:US
Mailing Address - Phone:405-329-3929
Mailing Address - Fax:405-366-1669
Practice Address - Street 1:817 24TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6313
Practice Address - Country:US
Practice Address - Phone:405-329-3929
Practice Address - Fax:405-366-1669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK155213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK481748228Medicare PIN
OK0739980002Medicare NSC
OK480002286Medicare PIN
OK480022761Medicare PIN
OKT40771Medicare UPIN