Organization
ALLEN K RAICH DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN K RAICH DPM (OWNER)
(901) 853-3015
Entity
Organization
Contact information
Practice address
1121 POPLAR VIEW LN N STE 2, COLLIERVILLE, TN 38017-9339
(901) 853-3018
(901) 853-3015
Mailing address
1121 POPLAR VIEW LN N STE 2, COLLIERVILLE, TN 38017-9339
(901) 853-3018
(901) 853-3015
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TNDPM228
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3731576
—
TN
01
—
4106735
BCBS OF TN
TN
01
—
900276068
RAILROAD MEDICARE
TN
Enumeration date
09/20/2006
Last updated
03/04/2014
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