Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DS3794 | TN |
NPI | 1073516902 |
---|---|
Provider Name | Dr. Steven C Keeton |
First Address | Knoxville, TN 37922-9468 |
Second Address | Knoxville, TN 37917-6413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 30/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5440564 | (05) | TN |