Organization
GEORGE KESHELAVA, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KESHELAVA MD (MD)
(985) 867-8585
Entity
Organization
Contact information
Practice address
1970 N HIGHWAY 190, COVINGTON, LA 70433-5158
(985) 867-8585
(985) 867-3644
Mailing address
PO BOX 1870, COVINGTON, LA 70434-1870
(985) 867-8585
(985) 867-3644
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD201497
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DV1138
RAILROAD MEDICARE
—
Enumeration date
04/14/2014
Last updated
08/03/2015
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