DR. OTIS GEORGE ALLEN (NPI# 1306847900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306847900 |
| Entity Type | Individual |
| Full Name | DR. OTIS GEORGE ALLEN |
| Credential | M.D. |
| Practice Address |
1215 Holiday Dr Bloomington IL 61704-2214 |
| Mailing Address |
53 Prenzler Dr Bloomington IL 61704-1299 |
| Practice Telephone | 3098273881 |
| Practice Fax Number | 3096610234 |
| Mailing Telephone | 3092878049 |
| Mailing Fax Number | 3096610234 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2016-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 036064804 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036064804 | 05 |
| Street Address |
1215 HOLIDAY DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-2214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457629842 | Otis Allen Md Sc | Plastic Surgery | 1215 Holiday Dr, Bloomington, IL 61704-2214 | 2011-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528152170 | Themistocles Peter Economou | Plastic Surgery | 7760 France Ave S Ste 1000, Bloomington, MN 55435-5870 | 2006-10-03 |
| 1518992528 | Alan Flint Wise | Plastic Surgery | 1455 W Bloomfield Rd, Bloomington, IN 47403-2010 | 2006-07-11 |
| 1306880216 | William Edward Weber Jr. | Plastic Surgery | 1455 W 2nd Street, Bloomington, IN 47403 | 2006-06-15 |
| 1699107797 | Paige C. Holt | Plastic Surgery | 2502 E Empire St, Ste C, Bloomington, IL 61704-3738 | 2013-07-31 |
| 1295173128 | Paige C Holt, Md, Ltd | Plastic Surgery | 2502 E Empire St, Suite C, Bloomington, IL 61704-3738 | 2013-06-13 |
| 1215276530 | Center for Cosmetic and Laser Surgery, LLC | Plastic Surgery | 1505 Eastland Dr, Ste 350, Bloomington, IL 61701-3534 | 2013-02-06 |
| 1457629842 | Otis Allen Md Sc | Plastic Surgery | 1215 Holiday Dr, Bloomington, IL 61704-2214 | 2011-12-13 |
| 1487943593 | Premier Medical Group, LLC | Plastic Surgery | 1505 Eastland Dr, Suite 350, Bloomington, IL 61701-3534 | 2011-03-30 |
| 1477718351 | Valerie Lemaine | Plastic Surgery | 7760 France Ave S Ste 1000, Bloomington, MN 55435-5870 | 2008-07-21 |
| 1225129570 | Plastic Surgery Associates of Southern Indiana PC | Plastic Surgery | 1455 W 2nd Street, Bloomington, IN 47403 | 2006-09-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on DR. OTIS GEORGE ALLEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.