Individual
DR. T KEITH MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
56 APPALACHIAN AVE, BLAIRSVILLE, GA 30512-2271
(706) 781-3994
(706) 781-3997
Mailing address
56 APPALACHIAN AVE, BLAIRSVILLE, GA 30512-2271
(706) 781-3994
(706) 781-3997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039632
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000717142B
—
GA
01
—
039632
LICENSE
GA
01
—
11D0962278
CLIA
GA
01
—
9601668
LICENSE
NC
Enumeration date
04/19/2006
Last updated
03/07/2023
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