Provider Demographics
NPI:1609962117
Name:KEITH, STEPHEN DANIEL JR (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DANIEL
Last Name:KEITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 W COLLEGE ST STE 2600
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5365
Mailing Address - Country:US
Mailing Address - Phone:256-766-2600
Mailing Address - Fax:256-383-1251
Practice Address - Street 1:1751 VETERANS DR STE 205
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4929
Practice Address - Country:US
Practice Address - Phone:256-766-2600
Practice Address - Fax:256-768-8658
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21441207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009941499Medicaid
AL051559121OtherMEDICARE
AL009941498Medicaid
AL51004809OtherBCBS AL
AL51538967OtherBCBS AL
AL51004809OtherBCBS AL