Individual
DAVID ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20963
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000321461
ANTHEM
KY
01
—
50001609
PASSPORT PORTLAND
KY
01
—
50001610
PASSPORT FD
KY
01
—
50001611
PASSPORT EB
KY
01
—
50001612
PASSPORT IQ
KY
01
—
50001614
PASSPORT PX
KY
01
—
50001926
PASSPORT ZE
KY
05
—
64209638
—
KY
Enumeration date
06/22/2005
Last updated
10/28/2016
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