Charles Joseph Keith Jr. (NPI# 1487098240, PAC ID# 1153561873) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1487098240 |
| PAC ID by PECOS | 1153561873 |
| Professional Enrollment ID | I20190813003688 |
| Full Name | Charles Joseph Keith Jr. |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Address |
1000 S Beckham Ave Tyler TX 75701-1908 |
| Phone Number | 9035905611 |
| Gender | M |
| Medical School | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 4486915600 |
| Number of Group Practice Members | 206 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450083 | EAST TEXAS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 18118 Fm 344, Ut Health East Texas Physicians, Flint, TX 75762-6010 | 9038253292 | ETMC PHYSICIAN GROUP, INC. |
| 1000 S Beckham Ave, Tyler, TX 75701-1908 | 9035905611 | ETMC PHYSICIAN GROUP, INC. |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Physicians | 178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Varalaxmi Nannaka | Pulmonary Disease | Etmc Physician Group, Inc. | 305 Cottage Rd, Carthage, TX 75633-1511 |
| Betsy Jill Chappell | Nurse Practitioner | Etmc Physician Group, Inc. | 406 E Hwy 243, Canton, TX 75103-2409 |
| Andrea Corine Cooley | Cardiac Surgery | Etmc Physician Group, Inc. | 1000 E 5th St, Suite 400, Tyler, TX 75701-3362 |
| Jason S Murry | General Surgery | Etmc Physician Group, Inc. | 1020 E Idel St, Ut Health East Texas Physicians, Tyler, TX 75701-2024 |
| Ronald J Pinkenburg | Ophthalmology | Etmc Physician Group, Inc. | 16911 Village Lake Dr, Lindale, TX 75771-5065 |
| Francine Fraser Mccain | Obstetrics/gynecology | Etmc Physician Group, Inc. | 1336 S Palestine St, Athens, TX 75751-3621 |
| Lori Fuquay | Nurse Practitioner | Etmc Physician Group, Inc. | 601 Hwy 110 N, Suite O, Whitehouse, TX 75791-3037 |
| Michael Jason Chastant | Nurse Practitioner | Etmc Physician Group, Inc. | 2608 Mcdonald Rd, Tyler, TX 75701-5934 |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Eric D Reed | Otolaryngology | Etmc Physician Group, Inc. | 301 W 19th St, Mt Pleasant, TX 75455-2322 |
| Street Address |
1000 S BECKHAM AVE |
| City | TYLER |
| State | TX |
| Zip | 75701-1908 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David R Dewalch | Physician Assistant | Etmc Physician Group, Inc. | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| R Kent Walker | Diagnostic Radiology | Tyler Radiology Associates, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Timothy J Leihgeber | Diagnostic Radiology | Tyler Radiology Associates, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Megan Moore | Certified Registered Nurse Anesthetist (crna) | U S Anesthesia Partners of Texas, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Alfred D Llave | Diagnostic Radiology | Tyler Radiology Associates, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Hugh P Babineau | General Surgery | Etmc Physician Group, Inc. | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Farzad Fakouri | Internal Medicine | Etmc Physician Group, Inc. | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Marta D Stanley | Physician Assistant | Tyler Radiology Associates, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Derek T Mitchell | Anesthesiology | U S Anesthesia Partners of Texas, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Ronald Rudak | Anesthesiology | U S Anesthesia Partners of Texas, Pa | 1000 S Beckham Ave, Tyler, TX 75701-1908 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose L Enriquez | Diagnostic Radiology | Tyler Radiology Associates, Pa | 1100 S Beckham, Tyler, TX 75701 |
| Frank P Reuter Jr. | Internal Medicine | 712 S Bois D Arc Ave, Tyler, TX 75701-1503 | |
| Tammy L Michaelsen | Chiropractic | Michaelsen Chiropractic Center, P.C. | 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 |
| Mark R Michaelsen | Chiropractic | Michaelsen Chiropractic Center, P.C. | 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 |
| James Louis Wasson | Obstetrics/gynecology | 649 S Broadway Ave, Suite 2, Tyler, TX 75701-1677 | |
| Michael C Ford | Ophthalmology | 714 Turtle Creek Dr, Tyler, TX 75701-1833 | |
| Rosalyn L Gooch | Certified Registered Nurse Anesthetist (crna) | Novamed Surgery Center of Tyler, Lp | 802 Turtle Creek Dr, Tyler, TX 75701-1900 |
| Evans S Smith | Emergency Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | |
| Li-yu H Mitchell | Family Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Find all physicians in zip 75701 | |||
| City | TYLER |
| Zip Code | 75701 |
| Specialty | GENERAL SURGERY |
| City + Specialty | TYLER + GENERAL SURGERY |
Please comment or provide details below to improve the information on Charles Joseph Keith Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.