Individual
DR. BRENT T ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 N NEW BALLAS RD, DIV SURG VASCULAR, STE 265, SAINT LOUIS, MO 63141-6825
(314) 991-4644
(866) 342-0133
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 991-4644
(866) 342-0133
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
R2B05
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202398723
—
MO
Enumeration date
07/03/2006
Last updated
04/15/2025
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