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General NPI Number Information
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NPI Number | 1104975002
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH KEATING M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 1080 LUMPKIN CAMPGROUND RD S SUITE 300
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City | DAWSONVILLE
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State | GA
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Zip | 30534-0989
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Country | US
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Telephone | 706-265-4100
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Fax | 706-265-4132
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Provider Business Mailing Address
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Address Line | 1080 LUMPKIN CAMPGROUND RD S STE 300
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City | DAWSONVILLE
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State | GA
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Zip | 30534-0989
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Country | US
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Telephone | 706-203-1217
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Fax | 706-265-4132
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 052971
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License Number State | GA
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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 | 052971
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License Number State | GA
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