Individual
MISTY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4022 LIBERTY ST, MILAN, TN 38358-3453
(731) 686-9744
(731) 613-2245
Mailing address
4022 LIBERTY ST, MILAN, TN 38358-3453
(731) 693-7588
(731) 693-7588
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
41832
TN
207Q00000X
Family Medicine Physician
Primary
41832
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103I088826
—
TN
05
—
3832640
—
TN
01
—
4146345
BCBS
—
01
—
4146351
BCBS
—
01
—
4153428
BLUE CROSS BLUE SHIELD
TN
Enumeration date
12/20/2006
Last updated
05/17/2023
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