Individual
MR. KEITH F. O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3671
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-8401
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
65039
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1869507
—
NJ
Enumeration date
01/23/2006
Last updated
06/16/2014
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