Allen, Lela Faircloth

Allen, Lela Faircloth is an individual health care provider with primary practice located at 2412 N Oak St , Valdosta GA 31602-2567. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Allen, Lela Faircloth can be contacted via phone (229) 244-1400.

Contact Information

Primary practice address
2412 N Oak St Valdosta GA 31602-2567
Phone: (229) 244-1400
Fax: (229) 244-5512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003754 Georgia

Profile Details

NPI number 1104024777
LBN Legal business name Allen, Lela Faircloth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2007
Last updated Jun 24th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104024777 NPPES
Georgia MEDICAID 622508818C

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