Provider Demographics
NPI:1184172868
Name:K.J. ALLAN, MD PC
Entity type:Organization
Organization Name:K.J. ALLAN, MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-282-4707
Mailing Address - Street 1:7350 E PROGRESS PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2130
Mailing Address - Country:US
Mailing Address - Phone:720-282-4707
Mailing Address - Fax:
Practice Address - Street 1:7350 E PROGRESS PL
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2130
Practice Address - Country:US
Practice Address - Phone:720-282-4707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0038390207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty