Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 5385 | WI |
Y | 213EG0000X | General Practice | 5385 | WI |
NPI | 1003062977 |
---|---|
Provider Name | Dr. James Paul Allen |
First Address | Onalaska, WI 54650-6703 |
Second Address | Onalaska, WI 54650-6703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 12/08/2008 |