Bernagie E Allen, MD

Individual provider Active NPI Family Medicine Physician · Fayetteville, AR

NPI 1255355996 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1255355996
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
C 8225 (AR)
Practice address
100 N College Ave
Fayetteville, AR 72701-5311
Phone
(479) 444-5016
Fax
(479) 587-5980
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C 8225ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Family Medicine Past Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C 8225 AR Yes

Addresses

Primary practice location

100 N College Ave
Fayetteville, AR 72701-5311

Mailing address

1629 N Rhonda Dr
Fayetteville, AR 72703-2042
Phone (479) 251-1913

Other providers in Fayetteville, AR

All providers in Fayetteville, AR · Family Medicine Physician in Arkansas

Sources for this page

Verify at the official NPI Registry.