Individual
DR. KEVIN RAY DIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 US HIGHWAY 84 W, OPP, AL 36467-3520
(334) 493-4357
(334) 222-3825
Mailing address
1800 US HIGHWAY 84 W, OPP, AL 36467-3520
(334) 493-4357
(334) 222-3825
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
2004010176
MO
208D00000X
General Practice Physician
Primary
30614
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102I016582
MEDICARE PTAN
AL
05
—
127794
—
AL
Enumeration date
11/02/2005
Last updated
10/25/2013
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