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Individual

RADCLIFF KIRKWOOD ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(770) 918-3000
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
055169
GA
208M00000X
Hospitalist Physician
Primary
55169
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
377949458A
GA
Enumeration date
05/08/2006
Last updated
05/26/2021
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