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General NPI Number Information
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NPI Number | 1356538961
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Entity Type | Organization
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Legal Business Name | KITTI K. OUTLAW, M.D., P.C.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 3715 DAUPHIN ST STE 6A
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City | MOBILE
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State | AL
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Zip | 36608-1774
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Country | US
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Telephone | 251-414-1333
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Fax | 251-414-3006
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Provider Business Mailing Address
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Address Line | 3715 DAUPHIN ST STE 6A
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City | MOBILE
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State | AL
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Zip | 36608-1774
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Country | US
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Telephone | 251-414-1333
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Fax | 251-414-3006
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. KITTI K OUTLAW
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Credential | MD
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Telephone | 251-414-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 00018171
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License Number State | AL
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