Healthcare Provider Details

I. General information

NPI: 1356439400
Provider Name (Legal Business Name): MARGARET BENNETT KEELING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 CHURCH ST NE SUITE 500
MARIETTA GA
30060-1110
US

IV. Provider business mailing address

699 CHURCH ST NE SUITE 500
MARIETTA GA
30060-1110
US

V. Phone/Fax

Practice location:
  • Phone: 770-793-9750
  • Fax: 770-919-0581
Mailing address:
  • Phone: 770-793-9750
  • Fax: 770-919-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number44377
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberAD9470826-503839
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME97309
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number60523
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: