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Organization
DRS. KETCHAM AND DISMUKES
Active
Organization
DRS. KETCHAM AND DISMUKES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA SMITH MAYTON (BILLING MANAGER)
(334) 289-0499
Entity
Organization
Contact information
Practice address
202 HWY 80 E, DEMOPOLIS, AL 36732
(334) 289-0499
(334) 289-3013
Mailing address
202 HWY 80 E, P.O. BOX 650, DEMOPOLIS, AL 36732
(334) 289-0499
(334) 289-3013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2802
AL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
03/19/2007
Last updated
12/10/2009
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