James Randall Deatherage

NPI #1265543797 in Brewton, Alabama

Provider Information

NPI Number: 1265543797
Entity Type: Individual
Name: James Randall Deatherage
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Aug 31, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 422 DOUGLAS AVENUE
City: Brewton
State: Alabama
ZIP Code: 36426
Phone: (251) 867-6837

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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