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Individual

LETICIA KATHRYN ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
60 MACK WALTERS RD, SHELBYVILLE, KY 40065-1738
(502) 633-4622
(502) 633-6925
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 633-4622
(502) 633-6925

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37109
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000226036
BLUE CROSS NUMBER
KY
01
64050362
KEN PAC NUMBER
KY
05
64050362
KY
Enumeration date
07/17/2006
Last updated
04/18/2018
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