Individual
JAMES K KEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, ANESTHESIA, SPRINGFIELD, MO 65804-2203
(417) 820-2829
(417) 829-8852
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2007012552
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316279953
—
MO
05
—
184223001
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00836337
RAILROAD MEDICARE
—
Enumeration date
02/08/2010
Last updated
11/19/2010
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