Individual
DR. MARK ROBERT KEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
805 PAMPLICO HWY STE 315, FLORENCE, SC 29505-6047
(843) 674-6460
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
028423
GA
207RH0003X
Hematology & Oncology Physician
Primary
51420
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00531649J
—
GA
01
—
221275
BLUE CROSS BLUE SHIELD
GA
01
—
4306466
AETNA
GA
01
—
604802700
UNITED HEALTHCARE
GA
01
—
830008428
RAILROAD MEDICARE
GA
05
—
G28423
—
SC
Enumeration date
12/29/2005
Last updated
01/25/2022
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