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Individual

LANCE O. ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D. O.

Contact information

Practice address
355 N MAIN ST, KANAB, UT 84741-3260
(435) 644-4100
(435) 644-3366
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
81778
WI
207Q00000X
Family Medicine Physician
Primary
362191-1204
UT
207Q00000X
Family Medicine Physician
MEDO8306
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1627681
AK
01
K166413
MEDICARE PTAN
AK
Enumeration date
07/06/2010
Last updated
04/27/2026
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