Allen, Roosevelt

Allen, Roosevelt is an individual health care provider with primary practice located at 500 Medical Center Blvd Suite 220, Lawrenceville GA 30046. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Allen, Roosevelt can be contacted via phone (770) 963-2451.

Contact Information

Primary practice address
500 Medical Center Blvd Suite 220 Lawrenceville GA 30046
Phone: (770) 963-2451
Fax: (770) 962-0017
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 036083 Georgia

Profile Details

NPI number 1326050485
LBN Legal business name Allen, Roosevelt
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Mar 7th, 2023 - 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 1326050485 NPPES
Georgia Other 340015405 RAILROAD MEDICARE

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