Individual
BRUCE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 SAINT JOSEPH LN, LONDON, KY 40741-8345
(606) 330-2370
(606) 877-1593
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-2370
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
55522
KY
208600000X
Surgery Physician
G30889
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G30889
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55522
KY MEDICAL LICENSE
KY
01
—
G30889
LICENSE
CA
05
—
YYY34803Y
—
CA
Enumeration date
02/09/2007
Last updated
06/16/2021
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