MEDICARE: JULIA ANN KEATING 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	207R00000X	Internal Medicine Physician	8788	NM

General Provider Information

NPI Number	:	1366475956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA ANN KEATING MD

Provider Business Mailing Address
First Line	:	PO BOX 51375
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87181-1375
Country	:	US
Telephone Number	:	505-243-7717
Fax Number	:	505-245-7117

Provider Business Practice Location Address
First Line	:	717 ENCINO PL NE
Second Line	:	SUITE 17
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2611
Country	:	US
Telephone Number	:	505-243-7717
Fax Number	:	505-245-7117

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

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	10/02/2007

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Directions to “ JULIA ANN KEATING MD” Practice Location

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