Individual
KATTIE J ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 SE PLAZA AVE STE 5, BENTONVILLE, AR 72712-5473
(479) 876-8550
(479) 208-4266
Mailing address
1651 E STEARNS ST STE 110, FAYETTEVILLE, AR 72703-6196
(479) 876-8550
(479) 208-4266
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
E7618
AR
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
E7618
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00665857
RAILROAD MEDICARE
MN
Enumeration date
07/23/2007
Last updated
11/03/2025
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