Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 3355 | TN |
NPI | 1295081065 |
---|---|
Provider Name | Dr. Forrest Pendleton Allen |
First Address | Fortson, GA 31808-0370 |
Second Address | Nashville, TN 37211-3980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2012 |
Last Update Date | 22/03/2021 |