Individual
DR. JOHN BRADLEY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13532 STEELECROFT PKWY, CHARLOTTE, NC 28278-7545
(704) 295-3475
(704) 295-3476
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 295-3448
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2017-00467
NC
207WX0107X
Retina Specialist (Ophthalmology) Physician
2017-00467
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122221
—
OH
05
—
NC3146
—
SC
Enumeration date
05/31/2011
Last updated
04/27/2021
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