Healthcare Provider Details

I. General information

NPI: 1417954850
Provider Name (Legal Business Name): KEITH WESTLEY SHILLITO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9550 E GOLF LINKS RD STE 100
TUCSON AZ
85730-1400
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 520-910-0207
  • Fax: 855-576-4748
Mailing address:
  • Phone: 888-987-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number32755
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: