Provider Demographics
NPI:1700173291
Name:ALLEN, WILLIAM LAWTON (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LAWTON
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1364 INTERSTATE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-6187
Mailing Address - Country:US
Mailing Address - Phone:931-456-8880
Mailing Address - Fax:931-456-8883
Practice Address - Street 1:408 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3709
Practice Address - Country:US
Practice Address - Phone:931-879-8931
Practice Address - Fax:931-879-8932
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC2522111N00000X
MSDC1178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSDC1178OtherLICENSE #
TN4312554OtherBCBS
TNDC2522OtherLICENSE #
MSDC1178OtherLICENSE #
MS7696844OtherAETNA
TNDC2522OtherLICENSE #
TN4312554OtherBCBS