MEDICARE: THOMAS KEETON

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	307993	KY

General Provider Information

NPI Number	:	1366378440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS KEETON

Provider Business Mailing Address
First Line	:	PO BOX 790
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41105-0790
Country	:	US
Telephone Number	:	606-329-8588
Fax Number	:	606-329-8588

Provider Business Practice Location Address
First Line	:	400 CW STEVENS BLVD
Second Line	:
City	:	GRAYSON
State	:	KY
Zip	:	41143-2014
Country	:	US
Telephone Number	:	866-233-1955
Fax Number	:

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

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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Directions to “ THOMAS KEETON ” Practice Location

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