Individual
DONALD WAIN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
142 SOUTH 50 EAST, POB 865, COALVILLE, UT 84017-0865
(435) 336-4403
(435) 336-5570
Mailing address
PO BOX 730, COALVILLE, UT 84017-0730
(435) 640-2524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
171351-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-3815
MEDICARE RHC
UT
01
—
46-3816
MEDICARE RHC
UT
Enumeration date
07/26/2006
Last updated
04/26/2017
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