Provider Demographics
NPI:1194313551
Name:KEATING, JOSEPH MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:KEATING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:KEATING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8415 MIDLAND SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2135
Mailing Address - Country:US
Mailing Address - Phone:334-663-9041
Mailing Address - Fax:205-262-3767
Practice Address - Street 1:3715 US HIGHWAY 431 N
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-2363
Practice Address - Country:US
Practice Address - Phone:334-732-2267
Practice Address - Fax:205-262-3767
Is Sole Proprietor?:No
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029089183500000X
AL11593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL11593OtherALABAMA PHARMACY LICENSE
351874OtherNABP
GARPH029089OtherGEORGIA PHARMACY LICENSE