MEDICARE: DR. JOHN G KEATING M.D.

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	174400000X	Specialist		GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356545289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN G KEATING M.D.

Provider Business Mailing Address
First Line	:	4035 WHITEWATER CREEK RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-3946
Country	:	US
Telephone Number	:	404-262-9161
Fax Number	:	404-233-0490

Provider Business Practice Location Address
First Line	:	3715 NORTHSIDE PKWY NW
Second Line	:	BUILDING 400 SUITE 150
City	:	ATLANTA
State	:	GA
Zip	:	30327-2806
Country	:	US
Telephone Number	:	404-233-5252
Fax Number	:	404-233-0490

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

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. JOHN G KEATING M.D.” Practice Location

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