Individual
DR. MARTY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 NICHOLASVILLE RD, STE 602, LEXINGTON, KY 40503-1404
(859) 277-4005
(859) 278-2507
Mailing address
1720 NICHOLASVILLE RD, STE 602, LEXINGTON, KY 40503-1404
(859) 277-4005
(859) 278-2507
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
39516
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000703653
ANTHEM- NIS
KY
01
—
000057119E
HUMANA- NIS
KY
05
—
200868800
—
IN
01
—
50031894
PASSPORT- NIS
KY
05
—
7100008660
—
KY
01
—
P00912388
RAILROAD MEDICARE- NIS
KY
Enumeration date
02/02/2007
Last updated
03/14/2013
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