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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437193927 | NPPES |
| Georgia | MEDICAID | 299512679C | |
| Georgia | Other | P001145189 | |
| Georgia | Other | 083704148 |
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