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NPI Code Detail

MEDICARE: KEITH E JUNIOR M.D.

MEDICARE: KEITH E JUNIOR 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
1207R00000XInternal Medicine Physician21938TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811911449
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH E JUNIOR M.D.
Provider Business Mailing Address
First Line : 617 S 8TH ST
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3819
Country : US
Telephone Number : 615-226-1695
Fax Number : 615-226-2679
Provider Business Practice Location Address
First Line : 617 S 8TH ST
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3819
Country : US
Telephone Number : 615-228-8902
Fax Number : 615-226-2679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 01/07/2011

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