Provider Demographics
NPI:1699773994
Name:ALLMAN, REX ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:REX
Middle Name:ALLEN
Last Name:ALLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:540 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WINAMAC
Mailing Address - State:IN
Mailing Address - Zip Code:46996-1173
Mailing Address - Country:US
Mailing Address - Phone:574-946-2194
Mailing Address - Fax:574-946-2196
Practice Address - Street 1:540 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WINAMAC
Practice Address - State:IN
Practice Address - Zip Code:46996-1173
Practice Address - Country:US
Practice Address - Phone:574-946-2194
Practice Address - Fax:574-946-2196
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0103116B207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100210650AMedicaid
INC25440Medicare UPIN
INC25440Medicare UPIN