Provider Demographics
NPI:1699039024
Name:SAVITT, ALLEN JACK (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:JACK
Last Name:SAVITT
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 1:4021 GULF SHORE BLVD N
Mailing Address - Street 2:#701
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3471
Mailing Address - Country:US
Mailing Address - Phone:239-649-0536
Mailing Address - Fax:
Practice Address - Street 1:4021 GULF SHORE BLVD N
Practice Address - Street 2:#701
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3471
Practice Address - Country:US
Practice Address - Phone:239-649-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1403020174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist