Provider Demographics
NPI:1023053535
Name:GIRTON, KEITH (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:GIRTON
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 1:644 EDEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-6031
Mailing Address - Country:US
Mailing Address - Phone:513-572-8670
Mailing Address - Fax:
Practice Address - Street 1:644 EDEN PARK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-6031
Practice Address - Country:US
Practice Address - Phone:513-572-8670
Practice Address - Fax:513-572-8489
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108983207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4454419Medicaid
FLAS1839572OtherHIGHMARK BCBS
FLB41990OtherMEDICARE UPIN