Keith, Jeanette N

Keith, Jeanette N is an individual health care provider with primary practice located at 1208 Somerville Rd Se , Decatur AL 35601-4335. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Keith, Jeanette N can be contacted via phone (256) 973-2700.

Contact Information

Primary practice address
1208 Somerville Rd Se Decatur AL 35601-4335
Fax: (256) 686-3342
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 036098638 Illinois
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 27942 Alabama

Profile Details

NPI number 1124180674
LBN Legal business name Keith, Jeanette N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated May 5th, 2020 - about 4 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 1124180674 NPPES
Illinois MEDICAID 036098638
Illinois MEDICAID 147364

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