# DRS. KETCHAM AND DISMUKES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720102387
- **Authorized official:** MRS. LINDA SMITH MAYTON (BILLING MANAGER)
- **Authorized official phone:** (334) 289-0499

## Contact information

- **Practice address:** 202 HWY 80 E, DEMOPOLIS, AL 36732
- **Practice address phone:** (334) 289-0499
- **Practice address fax:** (334) 289-3013
- **Mailing address:** 202 HWY 80 E, P.O. BOX 650, DEMOPOLIS, AL 36732
- **Mailing address phone:** (334) 289-0499
- **Mailing address fax:** (334) 289-3013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2802 | AL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 12/10/2009