Dr Keith Dismukes L.l.c. | |
202 Us Highway 80 E Demopolis AL 36732-3622 | |
(334) 289-0499 | |
(334) 289-3013 |
Full Name | Dr Keith Dismukes L.l.c. |
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Speciality | Clinic/Center |
Location | 202 Us Highway 80 E, Demopolis, Alabama |
Authorized Official Name and Position | Lauri Anne Cameron (ASST. OFFICE MANAGER) |
Authorized Official Contact | 3342872584 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr Keith Dismukes L.l.c. Po Box 650 P.o. Box 650 Demopolis AL 36732-0650 Ph: (334) 289-0499 | Dr Keith Dismukes L.l.c. 202 Us Highway 80 E Demopolis AL 36732-3622 Ph: (334) 289-0499 |
NPI Number | 1801161138 |
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Provider Enumeration Date | 03/20/2012 |
Last Update Date | 03/20/2012 |
Medicare PECOS PAC ID | 8527221233 |
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Medicare Enrollment ID | O20120516000465 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801161138 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | AD7121724 (Alabama) | Primary |
Provider Name | Keith A Dismukes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295749059 PECOS PAC ID: 3779626643 Enrollment ID: I20100202000065 |
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