NPI 1124036520 · live from the CMS NPI Registry
Tracy L. Allen, P.A.
Physician Assistant, Medical in Blue Ridge, GA. National Provider Identifier 1124036520, active.
NPI record
| NPI | 1124036520 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 101 Riverstone Vis, Suite 111, Blue Ridge, GA 30513 |
| Practice phone | 706-946-4200 |
| Enumerated | August 3, 2006 |
| Last updated | June 21, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PA-440 (ME) |
| Physician Assistant, Medical primary | 363AM0700X | 005894 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.