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Individual

DR. DOUGLAS SCOTT KEITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5149 N 9TH AVE, PENSACOLA, FL 32504-8756
(850) 416-1080
(850) 416-1089
Mailing address
4205 BELFORT RD, STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME128786
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017974800
FL
01
ME128786
FLORIDA MEDICAL LICENSURE
FL
01
P01853620
FLORIDA RR MEDICARE
FL
Enumeration date
11/28/2007
Last updated
07/21/2022
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