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Individual

DR. DAVID K DEETS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
215 E 1ST ST, STE 326 KSB MEDICAL GROUP, DIXON, IL 61021-3166
(815) 284-5719
(815) 285-5894
Mailing address
215 E 1ST ST, STE 326 KSB MEDICAL GROUP, DIXON, IL 61021-3166
(815) 284-5719
(815) 285-5894

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036-0482660
IL
208D00000X
General Practice Physician
Primary
036-0482660
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036048266
IL
Enumeration date
01/27/2006
Last updated
10/17/2008
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