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NPI Code Detail

MEDICARE: GERALD E KEIGHTLEY M.D.

MEDICARE: GERALD E KEIGHTLEY 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
1207RN0300XNephrology Physician0101047191VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
159426OTHERVASOUTHERN HEALTH
2052647OTHERVAANTHEM BLUE CROSS
3202213OTHERVACIGNA
431247OTHERVACARENET
5597421OTHERVAAETNA
6228371OTHERVAMAMSI
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8541497804OTHERTRICARE CHAMPUS

General Provider Information

NPI Number : 1447256482
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALD E KEIGHTLEY M.D.
Provider Business Mailing Address
First Line : 7501 RIGHT FLANK RD STE 600
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-3863
Country : US
Telephone Number : 804-559-6980
Fax Number : 804-559-6982
Provider Business Practice Location Address
First Line : 7501 RIGHT FLANK RD STE 600
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-3863
Country : US
Telephone Number : 804-559-6980
Fax Number : 804-559-6982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 02/05/2026

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Directions to “ GERALD E KEIGHTLEY M.D.” Practice Location

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