Provider Demographics
NPI:1619959954
Name:KEEGAN, KIRK ARLINGTON III (MD)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:ARLINGTON
Last Name:KEEGAN
Suffix:III
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:A1302 MEDICAL CENTER NORTH - DEPARTMENT OF UROLOGIC SUR
Mailing Address - Street 2:VANDERBILT UNIVERSITY MEDICAL CENTER
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-2765
Mailing Address - Country:US
Mailing Address - Phone:615-322-2101
Mailing Address - Fax:615-322-8990
Practice Address - Street 1:A1302 MEDICAL CENTER NORTH - DEPARTMENT OF UROLOGIC SUR
Practice Address - Street 2:VANDERBILT UNIVERSITY MEDICAL CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2765
Practice Address - Country:US
Practice Address - Phone:615-322-2101
Practice Address - Fax:615-322-8990
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46405208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN