Healthcare Provider Details

I. General information

NPI: 1720906506
Provider Name (Legal Business Name): ROBERT GAIL KEETON BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 NW 39TH EXPY
BETHANY OK
73008-2513
US

IV. Provider business mailing address

1117 SONGBIRD LN
BLANCHARD OK
73010-8506
US

V. Phone/Fax

Practice location:
  • Phone: 405-789-6711
  • Fax:
Mailing address:
  • Phone: 580-890-9636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number211221
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number211221
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number211221
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: