Healthcare Provider Details

I. General information

NPI: 1326194358
Provider Name (Legal Business Name): JOHN SPURGEON KEEBLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE B123
MOBILE AL
36608-3764
US

IV. Provider business mailing address

6701 AIRPORT BLVD STE B123
MOBILE AL
36608-3764
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-2323
  • Fax: 251-633-2463
Mailing address:
  • Phone: 251-633-2323
  • Fax: 251-633-2463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD 8321
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: