Provider Demographics
NPI:1053604546
Name:SHARPTON, KEITH THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:THOMAS
Last Name:SHARPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:401 MULBERRY ST SW STE 202
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5463
Mailing Address - Country:US
Mailing Address - Phone:828-757-6146
Mailing Address - Fax:
Practice Address - Street 1:401 MULBERRY ST SW STE 202
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5463
Practice Address - Country:US
Practice Address - Phone:828-757-6146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288887208600000X
NC2020-02577208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery