James R. Deatherage D.m.d.,p.c.

NPI #1730404187 in Brewton, Alabama

Provider Information

NPI Number: 1730404187
Entity Type: Organization
Organization Name: James R. Deatherage D.m.d.,p.c.
Primary Specialty: Dentist
Enumeration Date: Mar 29, 2010
Last Updated: Mar 29, 2010

Practice Location

Address: 422 DOUGLAS AVE
City: Brewton
State: Alabama
ZIP Code: 36426-2052
Phone: (251) 867-6837

Authorized Official

Name: MRS. BECKY JANE BARROW
Title: OFFICE MANAGER
Phone: (251) 867-6837

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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