Provider Demographics
NPI:1659711166
Name:ALLEN-LOPEZ, KELLY E (DO)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:E
Last Name:ALLEN-LOPEZ
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 1:563 STATE ROUTE 34
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-7000
Mailing Address - Country:US
Mailing Address - Phone:304-757-5063
Mailing Address - Fax:
Practice Address - Street 1:563 STATE ROUTE 34
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-7000
Practice Address - Country:US
Practice Address - Phone:304-757-5063
Practice Address - Fax:304-438-6759
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine