Individual
LELA FAIRCLOTH ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2412 N OAK ST, VALDOSTA, GA 31602-2567
(229) 244-1400
(229) 244-5512
Mailing address
2412 N OAK ST, VALDOSTA, GA 31602-2567
(292) 244-1400
(229) 244-5512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003754
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
622508818C
—
GA
Enumeration date
07/05/2007
Last updated
03/17/2026
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