Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | C-4795 | AR |
NPI | 1033175138 |
---|---|
Provider Name | James Davis Allen |
First Address | Batesville, AR 72501-7331 |
Second Address | Batesville, AR 72501-7331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 16/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104417001 | (05) | AR |
200016304 | PALMETTO GBA RAILROAD (01) | AR |
341459 | HEALTHLINK (01) | AR |
500927052 | MEDICARE ID - TYPE UNSPEC (01) | |
D84042 | (02) | AR |
QUALCHOICE | 13314000000 (01) | AR |