MEDICARE: DR. GARY J KEOGH 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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	24656	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051005486	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1790779577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY J KEOGH MD

Provider Business Mailing Address
First Line	:	4619 SPRING HILL AVE
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-5709
Country	:	US
Telephone Number	:	251-633-7211
Fax Number	:	251-410-6079

Provider Business Practice Location Address
First Line	:	3715 HIGHWAY 280-431 NORTH
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867
Country	:	US
Telephone Number	:	251-633-7211
Fax Number	:	251-410-6079

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	09/17/2019

Similar Medicare Providers

1043198229 — HANDS OF REFUGE HOME CARE LLC
Practice Location Address:

1206 BROAD ST STE 202
PHENIX CITY, AL
36867-5906

Practice Phone: 334-209-3909
Practice Fax: 334-209-4480

1013590363 — DR. DARREN PATEL DO
Practice Location Address:

4401 RIVER CHASE DRIVE
PHENIX CITY, AL
36867

Practice Phone: 334-732-3083
Practice Fax:

1083607618 — RICHARD A VALENTINE MD
Practice Location Address:

1615 21ST CT
PHENIX CITY, AL
36867-3727

Practice Phone: 334-297-4883
Practice Fax:

1154318285 — JENIFER D. NOBLES PAAA
Practice Location Address:

4401 RIVER CHASE DR
PHENIX CITY, AL
36867-7483

Practice Phone: 334-732-3000
Practice Fax:

1851388789 — HOME MEDICAL CARE COMPANY
Practice Location Address:

1709 CRAWFORD RD
PHENIX CITY, AL
36867-4230

Practice Phone: 334-291-0900
Practice Fax: 334-291-0066

1457332173 — LINDA SUE BORKAT R.N.
Practice Location Address:

1810 STADIUM DR , SUITE 220
PHENIX CITY, AL
36867-3100

Practice Phone: 334-664-0210
Practice Fax: 334-664-0217

Directions to “ DR. GARY J KEOGH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.