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General NPI Number Information
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NPI Number | 1316164288
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Entity Type | Individual
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Provider Name | JOHN STEWART KEELEY JR. MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 3647 J DEWEY GRAY CIR STE 200
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City | AUGUSTA
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State | GA
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Zip | 30909-2205
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Country | US
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Telephone | 706-504-9712
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Fax | 706-504-9703
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Provider Business Mailing Address
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Address Line | 105 W STONE DR STE 6A
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City | KINGSPORT
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State | TN
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Zip | 37660-3256
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Country | US
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Telephone | 423-408-7220
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Fax | 423-408-7405
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 49812
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 68360
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD27894
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD27894
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License Number State | ME
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Taxonomy #5
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 68360
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 49812
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License Number State | TN
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