Provider Demographics
NPI:1710928874
Name:RAMSEY, KEITH GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:GREGORY
Last Name:RAMSEY
Suffix:
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 1:804 ESTATE DR S
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-3082
Mailing Address - Country:US
Mailing Address - Phone:337-364-4089
Mailing Address - Fax:
Practice Address - Street 1:806 JEFFERSON TER
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560
Practice Address - Country:US
Practice Address - Phone:337-365-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12647R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1541109Medicaid
LAG72135Medicare UPIN
LA1541109Medicaid