Individual
KENT R ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3411 E LARK DR, CHANDLER, AZ 85286-5652
(877) 347-1557
(480) 588-7976
Mailing address
PO BOX 2240, GILBERT, AZ 85299-2240
(877) 347-1557
(480) 588-7976
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32403
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84464801
—
AZ
01
—
AZ07245480
BCBS
AZ
01
—
P00110674
RR MEDICARE
AZ
Enumeration date
03/28/2006
Last updated
11/07/2007
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