1083793863 NPI number — ALLEN L GEE MD, PHD

Table of content: ALLEN L GEE MD, PHD (NPI 1083793863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083793863 NPI number — ALLEN L GEE MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEE
Provider First Name:
ALLEN
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083793863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1008 13TH ST
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
CODY
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82414-3677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-578-1985
Provider Business Mailing Address Fax Number:
307-578-1938

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1008 13TH ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
CODY
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82414-3677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-578-1985
Provider Business Practice Location Address Fax Number:
307-578-1938
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  6448A , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 115509100 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com