Individual
DR. GEORGE C KEOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14490 OCEAN HWY, PAWLEYS ISLAND, SC 29585-4821
(843) 881-4440
(843) 314-0785
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
93326
SC
207N00000X
Dermatology Physician
MD0000035098
TN
207NS0135X
Procedural Dermatology Physician
MD0000035098
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3862971
—
TN
01
—
4145097
BLUE CROSS BLUE SHIELD
TN
01
—
7527158
AETNA
TN
Enumeration date
12/22/2005
Last updated
04/22/2025
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