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General NPI Number Information
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NPI Number | 1033528518
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Entity Type | Organization
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Legal Business Name | DR BILL KEATING, OD PA
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 8301 ROGERS AVE DOCTOR'S OFFICE
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City | FORT SMITH
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State | AR
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Zip | 72903-5236
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Country | US
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Telephone | 479-452-1580
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Fax | 479-452-6910
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Provider Business Mailing Address
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Address Line | PO BOX 10957
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City | FORT SMITH
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State | AR
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Zip | 72917-0957
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Country | US
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Telephone | 479-452-1580
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Fax | 479-452-6910
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Authorized Official
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Title or Position | OWNER
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Name | DR. BILL KEATING
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Credential | OD
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Telephone | 479-452-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AR2463
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License Number State | AR
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