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General NPI Number Information
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NPI Number | 1457415846
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Entity Type | Organization
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Legal Business Name | JOHN G. KEATING MD, PC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 3715 NORTHSIDE PKWY BUILDING 400, SUITE 150
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City | ATLANTA
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State | GA
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Zip | 30327
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Country | US
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Telephone | 404-233-5252
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Fax | 404-233-0490
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Provider Business Mailing Address
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Address Line | 3715 NORTHSIDE PKWY BUILDING 400, SUITE 150
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City | ATLANTA
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State | GA
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Zip | 30327
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Country | US
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Telephone | 404-233-5252
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Fax | 404-233-0490
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN G KEATING
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Credential | M.D.
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Telephone | 404-233-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 024444
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License Number State | GA
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