Provider Demographics
NPI:1851576920
Name:ALLEN, MARSHALL ANTHONY
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:ANTHONY
Last Name:ALLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1235
Mailing Address - Country:US
Mailing Address - Phone:859-236-2726
Mailing Address - Fax:859-236-0373
Practice Address - Street 1:650 HIGH ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1235
Practice Address - Country:US
Practice Address - Phone:859-236-2726
Practice Address - Fax:859-236-0373
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator