Provider Demographics
NPI:1306958459
Name:COMPTON, KEITH RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:RICHARD
Last Name:COMPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 33100
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-3100
Mailing Address - Country:US
Mailing Address - Phone:314-590-7163
Mailing Address - Fax:
Practice Address - Street 1:UNIT 33100
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-3100
Practice Address - Country:US
Practice Address - Phone:314-590-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057050A208000000X
KY41259208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5712823OtherCIGNA- NORTON
KY3422580000OtherPASSPORT ADVANTAGE- CMA E-TOWN
KY000000534160OtherANTHEM- NORTON
KY50016039OtherPASSPORT- NORTON
KY000023028TOtherHUMANA- NORTON
KY090709OtherSIHO- NORTON
KY7100020590Medicaid
0998873Medicare PIN