Provider Demographics
NPI:1487728689
Name:ALLEN, JEFFREY MICHAEL (PHARM D, BCOP)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PHARM D, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 HOBBS STATION RD
Mailing Address - Street 2:LOUISVILLE
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2670
Mailing Address - Country:US
Mailing Address - Phone:502-938-5028
Mailing Address - Fax:
Practice Address - Street 1:10505 HOBBS STATION RD
Practice Address - Street 2:LOUISVILLE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2670
Practice Address - Country:US
Practice Address - Phone:800-232-9997
Practice Address - Fax:502-653-7106
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0121911835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology