MEDICARE: ERIC J KEYSER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	002978-1	NY
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	215435	MA
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	A73867	CA
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	23873	NV
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME115298	FL

General Provider Information

NPI Number	:	1083723803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC J KEYSER MD

Provider Business Mailing Address
First Line	:	PO BOX 100744
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-7956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 S MARYLAND PKWY STE 404
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2462
Country	:	US
Telephone Number	:	702-962-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	01/15/2024

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