Provider Demographics
NPI:1881766103
Name:KEATS, PHILIP K (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:K
Last Name:KEATS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:290 MADISON AVE
Mailing Address - Street 2:#3B
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-538-2222
Mailing Address - Fax:973-538-4041
Practice Address - Street 1:290 MADISON AVE
Practice Address - Street 2:#3B
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-538-2222
Practice Address - Fax:973-538-4041
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ33132207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ33132OtherBOARD OF MEDICAL EXAMINER
NY20729LOtherSTATE OF NY EDUCATION DEP
C59459Medicare UPIN