Individual
ALLEN R MOLLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 NW 64TH ST, OKLAHOMA CITY, OK 73116-9107
(572) 218-9900
Mailing address
PO BOX 411804, BOSTON, MA 02241-1804
(610) 644-8900
(484) 924-0053
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
22334
OK
2085R0204X
Vascular & Interventional Radiology Physician
036163488
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
22334
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200106970A
—
OK
01
—
248722910
MEDICARE
OK
01
—
249722912
MEDICARE
OK
01
—
P00974065
MEDICARE RAILROAD (RALLC)
OK
Enumeration date
02/14/2007
Last updated
01/27/2026
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