Provider Demographics
NPI:1730206277
Name:ALLEN, JAMES PHILLIP (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILLIP
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1611 S UTICA AVE
Mailing Address - Street 2:# 217
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4909
Mailing Address - Country:US
Mailing Address - Phone:918-744-3664
Mailing Address - Fax:918-748-7688
Practice Address - Street 1:1611 S UTICA AVE
Practice Address - Street 2:# 217
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4909
Practice Address - Country:US
Practice Address - Phone:918-744-3664
Practice Address - Fax:918-748-7688
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-10-31
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Provider Licenses
StateLicense IDTaxonomies
OK4171207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200113890AMedicaid