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General NPI Number Information
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NPI Number | 1831199934
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Entity Type | Individual
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Provider Name | THOMAS KEITH ALBERT DPM
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 200 READING AVE STE 101
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City | WEST READING
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State | PA
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Zip | 19611-1140
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Country | US
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Telephone | 610-374-3684
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Fax | 610-374-3227
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Provider Business Mailing Address
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Address Line | 138 OAK LN
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City | FLEETWOOD
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State | PA
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Zip | 19522-9035
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Country | US
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Telephone | 610-374-3684
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Fax | 610-374-3227
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC001706-L
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License Number State | PA
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