Provider Demographics
NPI:1821084096
Name:ALLEN, JOHN GEOFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GEOFFREY
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:GEOFFREY
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3794 OLENTANGY RIVER RD.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3455
Mailing Address - Country:US
Mailing Address - Phone:614-267-4122
Mailing Address - Fax:614-267-4242
Practice Address - Street 1:3794 OLENTANGY RIVER RD.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3455
Practice Address - Country:US
Practice Address - Phone:614-267-4122
Practice Address - Fax:614-267-4242
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056570207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0798406OtherAETNA
OH0819798Medicaid
OH000000120976OtherANTHEM BCBS
OH000000120976OtherANTHEM BCBS
OHAL0691272Medicare ID - Type Unspecified