Basic Information
| Provider Information | |||||||||
| NPI: | 1831143775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AYRONS | ||||||||
| FirstName: | KEITH | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 E CHURCH ST | ||||||||
| Address2: | STE 301 | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934545915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056147930 | ||||||||
| FaxNumber: | 8056147929 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 E CHURCH ST STE 301 | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934545915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053499393 | ||||||||
| FaxNumber: | 8053491155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2006 | ||||||||
| LastUpdateDate: | 10/03/2018 | ||||||||
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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 | 174400000X | N | Other Service Providers | Specialist | 207RH0003X | G151371 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 8912438 | 05 | NC | MEDICAID |