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Organization
ALLEN FAMILY MEDICINE PLLC
Active
Organization
ALLEN FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY S ALLEN (PRESIDENT)
(480) 699-2222
Entity
Organization
Contact information
Practice address
7233 E BASELINE RD, STE 126, MESA, AZ 85209-5007
(480) 699-2222
(480) 699-3033
Mailing address
7233 E BASELINE RD, STE 126, MESA, AZ 85209-5007
(480) 699-2222
(480) 699-3033
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
44915
AZ
207Q00000X
Family Medicine Physician
Primary
36540
AZ
208VP0000X
Pain Medicine Physician
44915
AZ
363AM0700X
Medical Physician Assistant
5521
AZ
363LP2300X
Primary Care Nurse Practitioner
F07141310
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119260-1215960638
MEDICARE PTAN
AZ
01
—
1952380925
NATIONAL PROVIDER ID
AZ
05
—
569897
—
AZ
Enumeration date
02/10/2012
Last updated
02/11/2015
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