Provider Demographics
NPI:1639260391
Name:KEATTS, AMI (MD)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:KEATTS
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 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-213-7750
Mailing Address - Fax:
Practice Address - Street 1:39 BEAM LN
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2348
Practice Address - Country:US
Practice Address - Phone:540-213-7750
Practice Address - Fax:540-213-7755
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057978207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10023204OtherOPTIMA HEALTH
VA10023204OtherOPTIMA HEALTH
VAC00248Medicare PIN