Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith M Heaton, MD

Individual provider Surgery Physician · NPI 1962485508

Keith M Heaton, MD is a Surgery Physician in St Louis Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2005.

Licensed in
MN
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone: (952) 993-3700
Fax: (952) 993-1750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 43664 (MN)

Record details

NPI number1962485508
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 29, 2005
Last updated in NPPESMarch 9, 2021
Certification dateMarch 9, 2021
Mailing address8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516

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