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Contact Information

JASON C ALLEN, DPM
3801 SANTA ROSA DR
KINGMAN, AZ86401-2311
 Phone: 928-263-4189
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JASON C ALLEN · (Male)

NPI # 1215997069
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 03/24/2006
Last updated 05/13/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AZ License # 0641
  • AZ Medicaid 094601
Hospital affiliation(s)
  • KINGMAN REGIONAL MEDICAL CENTER - (Acute Care)
    3269 STOCKTON HILL ROAD
    KINGMAN, AZ 86409
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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