Munoz, Keith W

Munoz, Keith W is an individual health care provider with primary practice located at 100 S Madison St , Thomasville GA 31792-5473. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Munoz, Keith W can be contacted via phone (229) 236-0831.

Contact Information

Primary practice address
100 S Madison St Thomasville GA 31792-5473
Phone: (229) 236-0831
Fax: (229) 236-0871
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004279 Georgia

Profile Details

NPI number 1437193927
LBN Legal business name Munoz, Keith W
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Jun 13th, 2013 - about 11 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 1437193927 NPPES
Georgia MEDICAID 299512679C
Georgia Other P001145189
Georgia Other 083704148

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