Provider Demographics
NPI:1699468538
Name:ALLEN, ROBERT WARREN SR
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WARREN
Last Name:ALLEN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 S HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-7126
Mailing Address - Country:US
Mailing Address - Phone:539-777-4390
Mailing Address - Fax:
Practice Address - Street 1:1838 S HUDSON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-7126
Practice Address - Country:US
Practice Address - Phone:539-777-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist