Provider Demographics
NPI:1528336989
Name:ALLEN, ZEGARY II (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ZEGARY
Middle Name:
Last Name:ALLEN
Suffix:II
Gender:M
Credentials:MD, PHD
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 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-746-1990
Mailing Address - Fax:859-746-3149
Practice Address - Street 1:7370 TURFWAY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-746-1990
Practice Address - Fax:859-746-3149
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01131207W00000X
KY50982207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCO153AOtherMEDICARE PTAN