Basic Information
| Provider Information | |||||||||
| NPI: | 1275817694 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEPHEN KEITH MD | ||||||||
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| OtherOrganizationName: | NW ALABAMA PRACTICE MANAGEMENT LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3115 NORTHINGTON CT | ||||||||
| Address2: | SUITE 138 | ||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356306353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567665762 | ||||||||
| FaxNumber: | 2567408842 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 S JACKSON HWY | ||||||||
| Address2: | SUITE 259 | ||||||||
| City: | SHEFFIELD | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356605769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567662600 | ||||||||
| FaxNumber: | 2563831251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2011 | ||||||||
| LastUpdateDate: | 10/04/2011 | ||||||||
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| AuthorizedOfficialLastName: | STRICKLAND | ||||||||
| AuthorizedOfficialFirstName: | MORRIS | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2563864673 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NW ALABAMA PRACTICE MANAGEMENT LLC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.