Provider Demographics
NPI:1134825672
Name:KEITH, THOMAS ASHLEY JR (CSFA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ASHLEY
Last Name:KEITH
Suffix:JR
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 KNOLL TOP LN APT 3004
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1571
Mailing Address - Country:US
Mailing Address - Phone:910-617-8886
Mailing Address - Fax:
Practice Address - Street 1:3001 KNOLL TOP LN APT 3004
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1571
Practice Address - Country:US
Practice Address - Phone:910-617-8886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN177948246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant