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:
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Health care specialties

SpecialtyCodeLicense #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 2 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 1639198781 NPPES
Arizona MEDICAID 495003
Arizona Other 2279

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