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Contact Information

KHADIJATU E ALLEN, MD
204 E 15TH ST
ALMA, GA31510
 Phone: 912-632-2952
 Fax: 912-632-8682
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for KHADIJATU E ALLEN · (Female)

NPI Number 1235185455
Status Active
Credentials MD
Entity Individual
Enumeration date 05/26/2006
Last updated 06/15/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 44669
  • FL Medicaid 051722401
  • GA Medicaid 00963344B
Hospital affiliation(s)
  • BACON COUNTY HOSPITAL - (Critical Access)
    302 SOUTH WAYNE STREET
    ALMA, GA 31510
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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