Individual
JUSTIN R ALLPHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3050 E RIVER BLUFF BLVD, OZARK, MO 65721-8807
(417) 820-5610
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-005215
IL
363A00000X
Physician Assistant
Primary
2016016570
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
10/02/2014
Last updated
06/16/2016
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