Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD0000043378 | TN |
NPI | 1063530541 |
---|---|
Provider Name | Dr. Robert Wayne Keeton JR. |
First Address | Sevierville, TN 37862-6921 |
Second Address | Sevierville, TN 37862-6921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/11/2012 |