Provider Demographics
NPI:1548499049
Name:ALLEN, ANTONI (MD)
Entity type:Individual
Prefix:
First Name:ANTONI
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 W 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4506
Mailing Address - Country:US
Mailing Address - Phone:303-424-7572
Mailing Address - Fax:303-424-1703
Practice Address - Street 1:7920 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4506
Practice Address - Country:US
Practice Address - Phone:303-424-7572
Practice Address - Fax:303-424-1703
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0052062207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology