Healthcare Provider Details

I. General information

NPI: 1760471197
Provider Name (Legal Business Name): TIMOTHY C KEYS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 HOSPITAL DR. STE. 101
LAFAYETTE LA
70503
US

IV. Provider business mailing address

155 HOSPITAL DR. STE. 101
LAFAYETTE LA
70503
US

V. Phone/Fax

Practice location:
  • Phone: 337-234-3204
  • Fax: 337-234-3204
Mailing address:
  • Phone: 337-234-3204
  • Fax: 337-234-3599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD.207462
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.207462
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: