Individual
BRUCE STUART ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1338 OLD FORSYTH RD, MACON, GA 31210-7205
(478) 471-7788
Mailing address
1338 OLD FORSYTH RD, MACON, GA 31210-7205
(478) 471-7788
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20294
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20294
GEORGIA MEDICAL LICENCE NUMBER
GA
Enumeration date
03/24/2013
Last updated
03/24/2013
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