Provider Demographics
NPI:1467072371
Name:KEATON, OLIVIA (DO)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:KEATON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:2340 CARTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7826
Practice Address - Country:US
Practice Address - Phone:606-325-9644
Practice Address - Fax:606-329-1207
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY05550207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine