Provider Demographics
NPI:1619068897
Name:ALLEN, DANIEL S (DPM)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 STOCKTRAIL AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3582
Mailing Address - Country:US
Mailing Address - Phone:307-686-1413
Mailing Address - Fax:307-688-7940
Practice Address - Street 1:508 STOCKTRAIL AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3582
Practice Address - Country:US
Practice Address - Phone:307-686-1413
Practice Address - Fax:307-688-7940
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY132213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200125640BMedicaid
IN200125640BMedicaid
U52053Medicare UPIN