Individual
DR. KEITH A KOWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20308 BEECHER ST, FAIRHOPE, AL 36532-3692
(404) 432-2391
Mailing address
1851 N MCKENZIE ST STE 106, FOLEY, AL 36535-4704
(251) 943-1117
(251) 943-1183
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
036199
GA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD.34240
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102I43287
MEDICARE
AL
05
—
179628
—
AL
01
—
511-69027
BCBS OF AL
AL
Enumeration date
06/27/2005
Last updated
06/11/2019
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