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NPI Code Detail

MEDICARE: DR. THOMAS A KEITH M.D.

MEDICARE:  DR. THOMAS A KEITH  M.D.
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
1207Q00000XFamily Medicine PhysicianM2363TX
2207Q00000XFamily Medicine PhysicianME111881FL

General Provider Information

NPI Number : 1154421717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS A KEITH M.D.
Provider Business Mailing Address
First Line : 404 BARCELONA AVE
Second Line :
City : VENICE
State : FL
Zip : 34285-1754
Country : US
Telephone Number : 941-483-4705
Fax Number :
Provider Business Practice Location Address
First Line : 606 4TH AVE W
Second Line :
City : PALMETTO
State : FL
Zip : 34221-5226
Country : US
Telephone Number : 941-722-7785
Fax Number : 941-729-5267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2006
Last Update Date : 05/18/2012

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Directions to “ DR. THOMAS A KEITH M.D.” Practice Location

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