Provider Demographics
NPI:1851378384
Name:KEEL, JOHN CURETON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CURETON
Last Name:KEEL
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 1:330 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-4292
Mailing Address - Fax:617-667-4296
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-4292
Practice Address - Fax:617-667-4296
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053769208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG53769Medicaid
GA822695202AMedicaid
GAP00224397OtherRR MEDICARE
GA822695202AMedicaid
GAP00224397OtherRR MEDICARE