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NPI Code Detail

MEDICARE: DR. JOHN T. KERIOTIS & ASSOCIATES, INC.

MEDICARE: DR. JOHN T. KERIOTIS & ASSOCIATES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristS-710-TA-549AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689890410
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. JOHN T. KERIOTIS & ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 1115 LAKE COLONY LN
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-7422
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 790 MONTGOMERY HWY
Second Line : SUITE 110
City : VESTAVIA
State : AL
Zip : 35216-1872
Country : US
Telephone Number : 205-979-3937
Fax Number : 205-824-3937
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN KERIOTIS
Credential : O.D.
Telephone Number : 205-586-2786
Provider Enumeration Date : 04/18/2007
Last Update Date : 11/03/2016

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