Allen, Samuel M.

Allen, Samuel M. is an individual health care provider with primary practice located at 603 S Archusa Ave , Quitman MS 39355-2331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Allen, Samuel M. can be contacted via phone (601) 776-2123.

Contact Information

Primary practice address
603 S Archusa Ave Quitman MS 39355-2331
Fax: (601) 776-6006
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 06374 Mississippi

Profile Details

NPI number 1003898412
LBN Legal business name Allen, Samuel M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2005
Last updated Nov 6th, 2013 - about 12 years ago

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 1003898412 NPPES
Other 010065827 RAILROAD MEDICARE
Other 730-07862 RAILROAD MEDICARE
MEDICAID 00014132 RAILROAD MEDICARE

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