MEDICARE: EMILY KEETER DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	POD433	NM
2	390200000X	Student in an Organized Health Care Education/Training Program
3	213ES0103X	Foot & Ankle Surgery Podiatrist	DPM898	TN

General Provider Information

NPI Number	:	1699208850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY KEETER DPM

Provider Business Mailing Address
First Line	:	3024 BUSINESS PARK CIR
Second Line	:
City	:	GOODLETTSVILLE
State	:	TN
Zip	:	37072-3132
Country	:	US
Telephone Number	:	615-239-2018
Fax Number	:	615-851-2018

Provider Business Practice Location Address
First Line	:	693 PRESIDENT PL STE 103
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-8601
Country	:	US
Telephone Number	:	615-220-8788
Fax Number	:	615-220-8688

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

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	03/14/2023

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Directions to “ EMILY KEETER DPM” Practice Location

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