Provider Demographics
NPI:1841451994
Name:ALLEN, JEFFREY STOCKWELL (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:STOCKWELL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 IMPERIAL GOLF COURSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-8138
Mailing Address - Country:US
Mailing Address - Phone:239-597-5550
Mailing Address - Fax:239-597-9240
Practice Address - Street 1:1970 IMPERIAL GOLF COURSE BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-8138
Practice Address - Country:US
Practice Address - Phone:239-597-5550
Practice Address - Fax:239-597-9240
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-21
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine