Provider Demographics
NPI:1154326619
Name:BARTON, KEITH ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALAN
Last Name:BARTON
Suffix:
Gender:M
Credentials:DO
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 188
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739
Mailing Address - Country:US
Mailing Address - Phone:732-264-1127
Mailing Address - Fax:732-264-0670
Practice Address - Street 1:655 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702
Practice Address - Country:US
Practice Address - Phone:732-450-6000
Practice Address - Fax:732-450-1798
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07847400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0062847Medicaid
I28377Medicare UPIN
NJ0062847Medicaid
NJ090406Medicare ID - Type Unspecified
NJ090406A01Medicare PIN
NJ090406CDZMedicare PIN