Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD20444 | OR |
NPI | 1093732653 |
---|---|
Provider Name | Dr. Glenn L Keiper JR. |
First Address | Eugene, OR 97401-4604 |
Second Address | Eugene, OR 97401-4604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 10/01/2012 |