Provider Demographics
NPI:1629023767
Name:KEELING, JAMES KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEITH
Last Name:KEELING
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:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633-0549
Mailing Address - Country:US
Mailing Address - Phone:903-693-6626
Mailing Address - Fax:
Practice Address - Street 1:409 COTTAGE RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633-1466
Practice Address - Country:US
Practice Address - Phone:903-694-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8614208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX063445302Medicaid
TX8F2650OtherBLUE CROSS OF TEXAS
TX063445303Medicaid
TX458846Medicare ID - Type Unspecified
TX063445302Medicaid