Plamondon, Keith A
Plamondon, Keith A is an individual health care provider with primary practice located at 802 Ainsworth Dr Ste B , Prescott AZ 86301-1623. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Plamondon, Keith A can be contacted via phone (928) 775-5567.Contact Information
Primary practice address
802 Ainsworth Dr Ste B
Prescott AZ 86301-1623
Phone: (928) 775-5567
Fax: (928) 772-1522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2279 | Arizona |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2279 | Arizona |
Profile Details
| NPI number | 1639198781 |
|---|---|
| LBN Legal business name | Plamondon, Keith A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Mar 23rd, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639198781 | NPPES |
| Arizona | MEDICAID | 495003 | |
| Arizona | Other | 2279 |
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