Organization
FAMILY MEDICINE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYELLON ALLEN M.D. (MD)
(985) 702-1220
Entity
Organization
Contact information
Practice address
6322 HIGHWAY 182 E STE 200, MORGAN CITY, LA 70380-2038
(985) 702-1220
(985) 702-9715
Mailing address
6322 HIGHWAY 182 E, MORGAN CITY, LA 70380-2038
(985) 702-1220
(985) 702-9715
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15521R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1464368
—
LA
01
—
5405870060
BLU E CROSS BLUE SHIELD
LA
01
—
DC6205
MEDICARE RAILROAD
LA
Enumeration date
04/08/2008
Last updated
04/15/2021
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