Individual
DR. JOHN ALEX ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
709 BREEDLOVE DR, MONROE, GA 30655-2055
(678) 635-3500
Mailing address
709 BREEDLOVE DR, MONROE, GA 30655-2055
(678) 635-3500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
27598
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
052330
GA
2084P0804X
Child & Adolescent Psychiatry Physician
27598
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003142497D
—
GA
05
—
052330
—
GA
05
—
275981
—
SC
01
—
AA77689636
MEDICARE
SC
Enumeration date
06/08/2005
Last updated
07/08/2024
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