Doctor Name: | DR. KITTI K OUTLAW |
NPI Number: | 1265435382 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M. D. P.C. |
License Number: | 18171 |
Business Practice Address: | 3290 Dauphin St Ste 204 Mobile, AL - 366064014 |
Business Phone Number: | 2514713671 |
Business Fax Number: | 2514713933 |
Mailing Address: | 3290 Dauphin St, Ste 204 MOBILE |
State: | AL |
Postal Code: | 366064014 |
Phone Number: | 2514713671 |
Fax Number: | 2514713933 |
NPI Enumeration Date: | 05/23/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/16/2006 |
NPI Reactivation Date: | 03/21/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 18171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |