Individual
DR. JEFFREY W. ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4121 DUTCHMANS LN, STE 503, LOUISVILLE, KY 40207-4707
(502) 899-6405
(502) 899-6407
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
31266
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026447Y
HUMANA/NHWM
—
01
—
00533145
MEDICARE/NHWM
KY
01
—
1115726
PASSPORT
KY
05
—
200260900A
—
IN
05
—
64312663
—
KY
Enumeration date
01/12/2006
Last updated
12/31/2020
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