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Individual

DR. JOHN DAVID ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
140 ALLEN COURT, NORTH AUGUSTA, SC 29860-1101
(803) 510-0007
(803) 510-0144
Mailing address
140 ALLEN COURT, NORTH AUGUSTA, SC 29860-1101
(803) 510-0007
(803) 510-0144

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28313
SC
2080A0000X
Pediatric Adolescent Medicine Physician
025091
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000477969E
GA
05
G25091
SC
05
GPA917
SC
Enumeration date
12/06/2005
Last updated
09/14/2023
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