Maryellon Allen, M.D.
Individual provider Active NPI Family Medicine Physician · Morgan City, LA
NPI 1396745907 · NPPES record last updated Apr 14, 2021
Key facts
- NPI
- 1396745907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 15521R (LA)
- Practice address
- 6322 Highway 182 E
Morgan City, LA 70380-2038 - Phone
- (985) 702-1220
- Fax
- (985) 702-9715
- NPI assigned
- Jul 26, 2005
- Sex
- Female
- Sole proprietor
- No
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15521R | LA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15521R | LA | Yes |
Addresses
Primary practice location
6322 Highway 182 E
Morgan City, LA 70380-2038
Mailing address
6322 Highway 182 E
Morgan City, LA 70380-2038
Phone (985) 702-1220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1464368 | Medicaid | LA |
Other providers in Morgan City, LA
- Robert Arman Adams III
- Advanced Laser Equipment, LLC
- Chinedu Rex Akunne
- Lianter W Albert
- Joshua James Alcina
- Anna S Aloisio
- Emily Richard Alpha
- Amis Surgical Assistants LLC
- Alana Gautreaux Andras
- Apex Anesthesia Associates LLC
All providers in Morgan City, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.