Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 056950 | GA |
NPI | 1891784104 |
---|---|
Provider Name | Dr. Arthur Harry Allen |
First Address | Murray, KY 42071-2400 |
Second Address | Murray, KY 42071-2400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
482753103D | (05) | GA |
I47537 | (02) | GA |