Individual
GEORGE T KESHELAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 STARBRUSH CIR, COVINGTON, LA 70433-7304
(985) 871-4155
(985) 871-4183
Mailing address
1810 LINDBERG DR STE 2100, SLIDELL, LA 70458-8160
(985) 871-4155
(985) 871-4183
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD.210497
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1075914
—
LA
01
—
374669ZKGQ
MEDICARE PTAN
LA
01
—
P01381034
RAILROAD MEDICARE
LA
Enumeration date
05/23/2007
Last updated
10/23/2024
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