Provider Demographics
NPI:1407602840
Name:KEYS, JAMES HUBERT III
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HUBERT
Last Name:KEYS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1584 CLUB HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48340-1484
Mailing Address - Country:US
Mailing Address - Phone:313-200-1531
Mailing Address - Fax:
Practice Address - Street 1:1584 CLUB HOUSE CT
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-1484
Practice Address - Country:US
Practice Address - Phone:313-200-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care