Provider Demographics
NPI:1215579321
Name:NABIL KEITH MD LLC
Entity Type:Organization
Organization Name:NABIL KEITH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-216-4444
Mailing Address - Street 1:6002 HIGHWAY 53 E STE 130
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6227
Mailing Address - Country:US
Mailing Address - Phone:706-216-4444
Mailing Address - Fax:706-429-1140
Practice Address - Street 1:6002 HIGHWAY 53 E STE 130
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6227
Practice Address - Country:US
Practice Address - Phone:706-265-8002
Practice Address - Fax:706-429-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty