Provider Demographics
NPI:1336424977
Name:KENNETH J. ALLAN, MD PC
Entity type:Organization
Organization Name:KENNETH J. ALLAN, MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-282-4707
Mailing Address - Street 1:7800 E ORCHARD RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2583
Mailing Address - Country:US
Mailing Address - Phone:720-282-4707
Mailing Address - Fax:
Practice Address - Street 1:7350 E PROGRESS PL STE 201
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2135
Practice Address - Country:US
Practice Address - Phone:720-282-4707
Practice Address - Fax:303-539-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR38390207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty