Provider Demographics
NPI: | 1679727416 |
---|---|
Name: | ALLEN, DESMOND PAUL (PHD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | DESMOND |
Middle Name: | PAUL |
Last Name: | ALLEN |
Suffix: | |
Gender: | M |
Credentials: | PHD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 406 N 5TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | OPELIKA |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 36801-4106 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 334-745-2731 |
Mailing Address - Fax: | 334-745-2731 |
Practice Address - Street 1: | 406 N 5TH ST |
Practice Address - Street 2: | |
Practice Address - City: | OPELIKA |
Practice Address - State: | AL |
Practice Address - Zip Code: | 36801-4106 |
Practice Address - Country: | US |
Practice Address - Phone: | 334-745-2731 |
Practice Address - Fax: | 334-745-2731 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-11-06 |
Last Update Date: | 2008-11-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | |
No | 2278C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Critical Care |
No | 2278G0305X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Geriatric Care |
No | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health |