Provider Demographics
NPI:1386625507
Name:NARITOKU, DEAN K (MD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:K
Last Name:NARITOKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-660-5108
Mailing Address - Fax:251-660-5792
Practice Address - Street 1:1601 CENTER STREET
Practice Address - Street 2:STE. 2S
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1512
Practice Address - Country:US
Practice Address - Phone:251-660-5108
Practice Address - Fax:251-660-5792
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360752012084N0400X
ALL.3010DP2084N0400X
AL333922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036075201Medicaid
IL256510Medicare PIN
AL510I130030Medicare PIN
IL036075201Medicaid
ILL60055Medicare PIN