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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KEITH A MICETICH, MD

Active

DR. KEITH A MICETICH, MD is a Specialist healthcare provider located in JACKSON, Tennessee. NPI 1427026137 is currently active in the NPPES registry. Verify at CMS.

Specialist · JACKSON, TN

Registration Details

NPI Number
1427026137
Provider Type
Individual
Gender
Male
NPI Issued
Mar 9, 2006 (20.289918572992 yrs)
Last Updated
Nov 2, 2011
License
26274 (TN)

Practice Information

Address
72 PHYSICIANS DR
JACKSON, TN, 383052070
Browse TN providers · Browse ZIP 38305
Phone
7316684455
Fax
7316689007
Primary Specialty
Specialist
174400000X

Other Specialist Providers in JACKSON, TN

Name Credential NPI
PATRICIA RENEE OBI MD 1043213150
DR. LARRY W CARRUTH M.D. 1306835483
DR. JACOB AELION M.D. 1679551501
SHYAMAL SARKAR MD 1841260767
MILTON O MEDEIROS MD 1366410599
DR. ODIE L BATTLES JR. M.D. 1164491387
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.