Individual
MRS. ALISA A. KEATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAAA
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 351-1745
(404) 351-7121
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004121
GA
367H00000X
Anesthesiologist Assistant
Primary
004121
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248113939
—
GA
Enumeration date
07/13/2006
Last updated
11/07/2013
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