Keeler, Gary Demetrick

Keeler, Gary Demetrick is an individual health care provider with primary practice located at 1000 Lakeland Square Ext Ste 700 , Flowood MS 39232-7648. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Keeler, Gary Demetrick can be contacted via phone (601) 936-3555.

Contact Information

Primary practice address
1000 Lakeland Square Ext Ste 700 Flowood MS 39232-7648
Phone: (601) 936-3555
Fax: (601) 936-3580
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3478 Mississippi
Dental Providers / Dentist 122300000X 8114 Tennessee

Profile Details

NPI number 1285815589
LBN Legal business name Keeler, Gary Demetrick
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2007
Last updated Nov 8th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285815589 NPPES
Mississippi MEDICAID 01880393

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