KEITH A MALLATT OD

Dr KEITH A MALLATT OD is a male medical professional, specializing in Optometry. He graduated in 1981 from University Of Houston - College Of Optometry.

Contact

719 E 7TH ST
GALENA
KS
667391703

Tel: 6207832191

KEITH A MALLATT OD Information

Npi 1386746857
Pac Id 8921054495
Professional Enrollment Id I20050328000806
Last Name MALLATT
First Name KEITH
Middle Name A
Suffix
Gender M
Credential OD
Medical School Name UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Graduation Year 1981
Primary Specialty OPTOMETRY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 719 E 7TH ST
Line 2 Street Address
Marker Of Address Line 2 Suppression
City GALENA
State KS
Zip Code 667391703
Phone Number 6207832191
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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