Organization · NPI-2
Allen Family Medicine PLLC
Family Medicine · Mesa, AZ
NPI number1356614176
StatusActive
Last updated in NPPESFeb 11, 2015
Details
- NPI
- 1356614176
- Entity type
- Organization (NPI-2)
- Legal business name
- Allen Family Medicine PLLC
- Organization subpart
- No
- Enumeration date
- Feb 10, 2012
- Last updated
- Feb 11, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 36540 | AZ | Yes |
| 208VP0000X | 44915 | AZ | ||
| 207LP2900X | Anesthesiology, Pain Medicine | 44915 | AZ | |
| 363LP2300X | Nurse Practitioner, Primary Care | F07141310 | AZ | |
| 363AM0700X | Physician Assistant, Medical | 5521 | AZ |
Practice location
7233 E Baseline RdSte 126
Mesa, AZ 85209-5007
Phone 480-699-2222 · Fax 480-699-3033
Mailing address
7233 E Baseline RdSte 126
Mesa, AZ 85209-5007
Phone 480-699-2222 · Fax 480-699-3033
Authorized official
Gregory S Allen
President
4806992222
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