Individual
SUZANNE C ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 MED TECH PKWY, SUITE 300, JOHNSON CITY, TN 37604-4007
(423) 926-6266
(423) 926-7599
Mailing address
PO BOX 5576, JOHNSON CITY, TN 37602-5576
(423) 926-6266
(423) 926-7599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD18324
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336171412
—
VA
05
—
3030161
—
TN
05
—
64919285
—
KY
01
—
930036323
RR MEDICARE
—
Enumeration date
07/07/2006
Last updated
03/11/2011
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