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General NPI Number Information
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NPI Number | 1053042408
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Entity Type | Individual
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Provider Name | KEATON JAMES FLETCHER DO
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Gender | Male
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1701 NW HAWTHORNE AVE
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City | GRANTS PASS
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State | OR
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Zip | 97526-1051
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Country | US
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Telephone | 541-472-4777
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Fax | 541-471-1439
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Provider Business Mailing Address
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Address Line | 1701 NW HAWTHORNE AVE
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City | GRANTS PASS
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State | OR
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Zip | 97526-1051
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Country | US
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Telephone | 541-472-4777
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Fax | 541-471-1439
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0542R
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO226364
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License Number State | OR
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