# ALLEN FAMILY MEDICINE PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356614176
- **Authorized official:** DR. GREGORY S ALLEN (PRESIDENT)
- **Authorized official phone:** (480) 699-2222

## Contact information

- **Practice address:** 7233 E BASELINE RD, STE 126, MESA, AZ 85209-5007
- **Practice address phone:** (480) 699-2222
- **Practice address fax:** (480) 699-3033
- **Mailing address:** 7233 E BASELINE RD, STE 126, MESA, AZ 85209-5007
- **Mailing address phone:** (480) 699-2222
- **Mailing address fax:** (480) 699-3033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 44915 | AZ | — |
| 207Q00000X | Family Medicine Physician | 36540 | AZ | Yes |
| 208VP0000X | Pain Medicine Physician | 44915 | AZ | — |
| 363AM0700X | Medical Physician Assistant | 5521 | AZ | — |
| 363LP2300X | Primary Care Nurse Practitioner | F07141310 | AZ | — |

## Other

- **Enumeration date:** 02/10/2012
- **Last updated:** 02/11/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 119260-1215960638 | MEDICARE PTAN | AZ |
| 01 | — | 1952380925 | NATIONAL PROVIDER ID | AZ |
| 05 | — | 569897 | — | AZ |