Provider Demographics
NPI:1730236530
Name:KEYS, KRISTAL TAMARA (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTAL
Middle Name:TAMARA
Last Name:KEYS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:400 W WILSON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TRENT WOODS
Mailing Address - State:NC
Mailing Address - Zip Code:28562-7540
Mailing Address - Country:US
Mailing Address - Phone:252-636-5509
Mailing Address - Fax:252-636-5583
Practice Address - Street 1:509 N BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4407
Practice Address - Country:US
Practice Address - Phone:252-636-5509
Practice Address - Fax:252-636-5583
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-01365207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology