Provider Demographics
NPI:1316929763
Name:KEATON, NANCY L (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:KEATON
Suffix:
Gender:F
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:PO BOX 1289
Mailing Address - Street 2:ASHBROOK RADIOLOGY
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1289
Mailing Address - Country:US
Mailing Address - Phone:828-684-2816
Mailing Address - Fax:
Practice Address - Street 1:254 TWO BROOKS TRL
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-7443
Practice Address - Country:US
Practice Address - Phone:828-684-2816
Practice Address - Fax:828-684-2068
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91008692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC47952OtherBCBSNC
NC8947952Medicaid
NCC76160Medicare UPIN
NC47952OtherBCBSNC
NC8947952Medicaid