| Doctor Name: | DR. MICHAEL JOHN ALLEN |
| NPI Number: | 1831346139 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS014491 |
| Business Practice Address: | 300 Hospital Road Fort Gordon, GA - 309055650 |
| Business Phone Number: | 7067872264 |
| Business Fax Number: | 7067879048 |
| Mailing Address: | 300 Hospital Rd, FORT GORDON |
| State: | GA |
| Postal Code: | 309055650 |
| Phone Number: | 7067872264 |
| Fax Number: | 7067879048 |
| NPI Enumeration Date: | 08/19/2008 |
| NPI Last Update Date: | 10/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS014491 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |