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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. IDI ALLEN, M.D.

Active Sole Proprietor

DR. IDI ALLEN, M.D. is a Interventional Vascular Surgery healthcare provider located in FAYETTEVILLE, Georgia. NPI 1700029402 is currently active in the NPPES registry. Verify at CMS.

Interventional Vascular Surgery · FAYETTEVILLE, GA

Registration Details

NPI Number
1700029402
Provider Type
Individual
Gender
Male
NPI Issued
Apr 9, 2009 (17.161266197619 yrs)
Last Updated
Mar 21, 2019
Licenses
70849 (GA)
70849 (GA)
70849 (GA)
70849 (GA)
Sole Proprietor
Yes

Practice Information

Address
101 YORKTOWN DR STE 211
FAYETTEVILLE, GA, 302141578
Browse GA providers · Browse ZIP 30214
Phone
4704812020
Primary Specialty
Interventional Vascular Surgery
208VP0014X
Additional Specialty
Pain Medicine
Additional Specialty
Vascular Surgery

Other Interventional Vascular Surgery Providers in FAYETTEVILLE, GA

Name Credential NPI
ZWADE J MARSHALL M.D. 1750671400
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.