Keith R. Allen
Cardiothoracic Vascular Surgeon
2115 S Fremont Ave Ste 5000
Springfield
, Missouri 65804-2239
Keith R. Allen
Cardiothoracic Vascular Surgeon
2115 S Fremont Ave Ste 5000
Springfield
, Missouri 65804-2239
(417) 829-4620
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Keith R. Allen
- Po Box 2580
- Springfield, MO
- Zip : 65801-2580
- Phone : (417) 829-4620
Second Address
- Keith R. Allen
- 2115 S Fremont Ave Ste 5000
- Springfield, MO
- Zip : 65804-2239
- Phone : (417) 820-3960
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2013025450 | MO |
National Provider Identifier
| NPI | 1134186901 |
|---|---|
| Provider Name | Keith R. Allen |
| First Address | Springfield, MO 65801-2580 |
| Second Address | Springfield, MO 65804-2239 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/04/2006 |
| Last Update Date | 08/11/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1134186901 | (05) | MO |
| 199362001 | (05) | AR |
| 431560263 | TRICARE (01) | MO |
| P01222589 | RR MCR (01) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.