Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 032323 | GA |
Y | 208600000X | Surgeon | 032323 | GA |
NPI | 1013972959 |
---|---|
Provider Name | Dr. Donald Keith West |
First Address | Marietta, GA 30060-1144 |
Second Address | Marietta, GA 30060-1144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 04/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00469774-A | (05) | GA |
E85325 | (02) | GA |