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Contact Information

KEATON PEAK
1108 ROSS CLARK CIR
DOTHAN, AL36301
 Phone: 334-793-8111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for KEATON PEAK · (Male)

NPI # 1467017335
Status Active
Credentials
Entity Individual
Enumeration date 05/07/2019
Last updated 09/11/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 1-147512
Hospital affiliation(s)
  • FLOWERS HOSPITAL - (Acute Care)
    4370 WEST MAIN STREET
    DOTHAN, AL 36305
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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