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Organization
KEITH M BANTON MD PA
Active
Organization
KEITH M BANTON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH M BANTON M.D. (PRESIDENT)
(850) 763-4700
Entity
Organization
Contact information
Practice address
3230 E 15TH ST, UNIT B, PANAMA CITY, FL 32405-7423
(850) 763-4700
(850) 763-4999
Mailing address
3230 E 15TH ST, UNIT B, PANAMA CITY, FL 32405-7423
(850) 763-4700
(850) 763-4999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME85024
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13636
BCBS OF FLORIDA
FL
05
—
265799600
—
FL
Enumeration date
09/29/2006
Last updated
04/28/2014
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