Provider Demographics
NPI:1730497520
Name:ALLEN, WILLIAM Z (PA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:Z
Last Name:ALLEN
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Gender:M
Credentials:PA
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Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:541-523-4415
Mailing Address - Fax:541-523-2399
Practice Address - Street 1:3175 POCAHONTAS.RD
Practice Address - Street 2:SAMG BAKER CLINIC FAMILY PRACTICE
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814
Practice Address - Country:US
Practice Address - Phone:541-523-4415
Practice Address - Fax:541-523-2399
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
ORPA152721363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant