Provider Demographics
NPI:1679700504
Name:ALLEN, RAYMOND KEELS JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:KEELS
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R.
Other - Middle Name:KEELS
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1599
Mailing Address - Street 2:CLINICAL PATHOLOGY CONSULTANTS, PA
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29528-1599
Mailing Address - Country:US
Mailing Address - Phone:843-347-7144
Mailing Address - Fax:843-347-7331
Practice Address - Street 1:300 SINGLETON RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9142
Practice Address - Country:US
Practice Address - Phone:843-347-7144
Practice Address - Fax:843-347-7331
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL31890207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology