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Individual

KEITH J WINDHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1912 AL HIGHWAY 157, ANESTHESIA DEPT, CULLMAN, AL 35058-0609
(256) 737-2882
(256) 737-2849
Mailing address
PO BOX 1108, CULLMAN, AL 35056-1108
(256) 737-2000
(256) 737-2849

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-065616
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51533380
BCBS #
AL
Enumeration date
07/24/2006
Last updated
04/11/2008
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