DR. Keith A Micetich, MD

NPI #1427026137 in Jackson, Tennessee

Provider Information

NPI Number: 1427026137
Entity Type: Individual
Name: DR. Keith A Micetich, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: MD
Enumeration Date: Mar 9, 2006
Last Updated: Nov 2, 2011

Practice Location

Address: 72 PHYSICIANS DR
City: Jackson
State: Tennessee
ZIP Code: 38305-2070
Phone: (731) 668-4455

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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