Individual
GRANT R ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
635 W COLLEGE ST, FLORENCE, AL 35630-5313
(256) 764-3431
Mailing address
635 W COLLEGE ST, FLORENCE, AL 35630-5313
(256) 764-3431
(256) 765-2036
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24600
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317560
—
AL
05
—
318488
—
AL
01
—
513-05147
BCBS
AL
Enumeration date
08/04/2006
Last updated
07/05/2024
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