Provider Demographics
NPI:1528266905
Name:ALLEN, JOSEPH EDGAR JR (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:EDGAR
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2640 HIGHWAY 105
Mailing Address - Street 2:STE 102
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7828
Mailing Address - Country:US
Mailing Address - Phone:828-262-1554
Mailing Address - Fax:828-268-2981
Practice Address - Street 1:2640 HIGHWAY 105 STE 102
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-322-2050
Practice Address - Fax:828-345-0522
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2019-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC201200284207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC018K8OtherBCBS GROUP #
NC7902495Medicaid
NC0319530001Medicare NSC
NC2344468Medicare PIN
NC018K8OtherBCBS GROUP #
NCNC5523AMedicare PIN