DR. COURTLAND KEITH KETEYIAN (NPI# 1821382235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821382235 |
| Entity Type | Individual |
| Full Name | DR. COURTLAND KEITH KETEYIAN |
| Credential | MD |
| Practice Address |
205 N. East Avenue Jackson MI 49201 |
| Practice Telephone | 5172055995 |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2017-01-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
4301098782 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
205 N. EAST AVENUE |
| City | JACKSON |
| State | MI |
| Zip Code | 49201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629206784 | Sarah Beth Poplawski | Physician Assistant | 205 N. East Avenue, Emergency Department, Jackson, MI 49201 | 2009-06-29 |
| 1003302159 | David Eugene Klein | Student in an Organized Health Care Education/Training Program | 205 N. East Avenue, 2nd Fl Cab, Jackson, MI 49201 | 2018-07-02 |
| 1093201162 | Shikha Rao | Student in an Organized Health Care Education/Training Program | 205 N. East Avenue, 2nd Fl Cab, Jackson, MI 49201 | 2018-07-02 |
| 1447602271 | Iman Suleiman | Student in an Organized Health Care Education/Training Program | 205 N. East Avenue, 2nd Fl Cab, Jackson, MI 49201 | 2016-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730697756 | Amy Schultz | Preventive Medicine | 1715 Lansing Ave Ste 221, Jackson, MI 49202-2193 | 2018-01-11 |
| 1710341771 | Sisters In Birth, Inc. | Preventive Medicine | 3000 Old Canton Rd Ste 280, Jackson, MS 39216-4255 | 2016-04-06 |
| 1851620314 | Frank J Morgan Jr. | Preventive Medicine | 1200 Meadowbrook Rd, #25, Jackson, MS 39206-6109 | 2009-12-12 |
| 1548306525 | Charlotte Deniece Coleman | Preventive Medicine | 295 Summar Avenue, West Tennesse Regional Office, Jackson, TN 38301 | 2007-01-29 |
| 1780692400 | Jackson County | Preventive Medicine | 1715 Lansing Ave, Jackson, MI 49202-2193 | 2006-08-05 |
| 1801227723 | Kidz Fitness Station | Preventive Medicine | 2460 Terry Rd, Jackson, MS 39204-5767 | 2013-12-02 |
| 1821252479 | Abedulnaasseer O. Mohammedelamien | Preventive Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2008-07-14 |
| 1821123670 | Paul E. Byers | Preventive Medicine | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2007-02-22 |
| 1376685750 | Karen K Codjoe | Preventive Medicine | 295 Summar Ave, Jackson, TN 38301 | 2007-02-13 |
| 1235283623 | Shavetta D Conner | Preventive Medicine | 295 Summar Ave, Jackson, TN 38301 | 2007-01-22 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.