Provider Demographics
NPI:1831269463
Name:ALLEN, JOHN CHRISTOPHER (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2765 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1828
Mailing Address - Country:US
Mailing Address - Phone:423-764-2299
Mailing Address - Fax:423-968-3340
Practice Address - Street 1:2765 W STATE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1828
Practice Address - Country:US
Practice Address - Phone:423-764-2299
Practice Address - Fax:423-968-3340
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM580213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7993366OtherAETNA
TN3353718Medicaid
VA404529OtherBLUE CROSS OF VIRGINIA
TN480034380OtherRAILROAD MEDICARE
TN3353635Medicaid
VA385776OtherBLUE CROSS OF VA FOR TN PATIENTS
VA480034380OtherRAILROAD MEDICARE
TN4042165OtherBLUE CROSS
TN3353635Medicaid
TNU91788Medicare UPIN
TN4517370001Medicare NSC
VAVAA101623Medicare PIN