Provider Demographics
NPI:1780203547
Name:ALLEN, DANIEL LAMAR JR (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LAMAR
Last Name:ALLEN
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4106 COLUMBIA RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-1482
Mailing Address - Country:US
Mailing Address - Phone:706-863-1440
Mailing Address - Fax:706-863-5418
Practice Address - Street 1:4106 COLUMBIA RD STE 103
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-1482
Practice Address - Country:US
Practice Address - Phone:706-863-1440
Practice Address - Fax:706-863-5418
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA95930208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics