Basic Information
| Provider Information | |||||||||
| NPI: | 1821051269 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEETON | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228031430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405645791 | ||||||||
| FaxNumber: | 5405647038 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | MOUNT JACKSON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228429417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404773185 | ||||||||
| FaxNumber: | 5404772666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 04/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101051846 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 700010069 | 01 | CIGNA | OTHER | 200312 | 01 | ANTHEM/BCBS | OTHER | 1000870001 | 01 | VA | DME PROVIDER | OTHER | 080071938 | 01 | RAILROAD MEDICARE | OTHER | 41197 | 01 | VA | OPTIMA | OTHER | 08113000000 | 01 | SOUTHERN HEALTH | OTHER | 5609305 | 05 | VA | MEDICAID |