Provider Demographics
NPI:1023050390
Name:KEETON, KARA GREENLEAT (MD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:GREENLEAT
Last Name:KEETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1050 SULLIVAN AVE
Mailing Address - Street 2:SUITE A4
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2000
Mailing Address - Country:US
Mailing Address - Phone:860-648-2748
Mailing Address - Fax:860-648-2751
Practice Address - Street 1:1050 SULLIVAN AVE
Practice Address - Street 2:SUITE A4
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2000
Practice Address - Country:US
Practice Address - Phone:860-648-2748
Practice Address - Fax:860-648-2751
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056113207V00000X
CT044552207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology