Provider Demographics
NPI:1891711073
Name:KEYS, ALAN C (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:C
Last Name:KEYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:233 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3538
Mailing Address - Country:US
Mailing Address - Phone:336-667-9300
Mailing Address - Fax:336-667-0655
Practice Address - Street 1:233 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3538
Practice Address - Country:US
Practice Address - Phone:336-667-9300
Practice Address - Fax:336-667-0655
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC38994208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8948749Medicaid
F00717Medicare UPIN
NC8948749Medicaid