Individual
DR. PHILLIP GLENN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4950 ESSEN LN, SUITE A, BATON ROUGE, LA 70809-3738
(225) 765-1765
(225) 765-1768
Mailing address
4950 ESSEN LN, SUITE A, BATON ROUGE, LA 70809-3738
(225) 765-1765
(225) 765-1768
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
050863
GA
207Y00000X
Otolaryngology Physician
050863
GA
207Y00000X
Otolaryngology Physician
Primary
205859
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000953994A
—
GA
05
—
01173018
—
MS
05
—
2348191
—
LA
Enumeration date
11/04/2005
Last updated
12/30/2020
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