MEDICARE: NANCY L. KEATON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	9100869	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	47952	OTHER	NC	BCBSNC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316929763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY L. KEATON MD

Provider Business Mailing Address
First Line	:	PO BOX 1289
Second Line	:	ASHBROOK RADIOLOGY
City	:	FLETCHER
State	:	NC
Zip	:	28732-1289
Country	:	US
Telephone Number	:	828-684-2816
Fax Number	:

Provider Business Practice Location Address
First Line	:	254 TWO BROOKS TRL
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732-7443
Country	:	US
Telephone Number	:	828-684-2816
Fax Number	:	828-684-2068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/08/2007

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