Provider Demographics
NPI:1104890995
Name:ALLMAN, JEFFREY WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:WILLIAM
Last Name:ALLMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6907
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302
Mailing Address - Country:US
Mailing Address - Phone:334-793-5000
Mailing Address - Fax:334-615-8419
Practice Address - Street 1:4370 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305
Practice Address - Country:US
Practice Address - Phone:334-793-5000
Practice Address - Fax:334-615-8419
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.447207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051515768Medicaid
263894100OtherFLORIDA MEDICAID
AL51527560OtherBCBS OF ALABAMA
P00055566OtherRAILROAD MEDICARE
LA1645702OtherMEDICAID
000833764EOtherGEORGIA MEDICAID
G11053Medicare UPIN
051515768Medicare ID - Type Unspecified