Dr. Keith Thomas Corpus
Sports Medicine Orthopaedic Surgeon
303 N William Kumpf Blvd
Peoria
, Illinois 61605
Dr. Keith Thomas Corpus
Sports Medicine Orthopaedic Surgeon
303 N William Kumpf Blvd
Peoria
, Illinois 61605
(309) 676-5546
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About
Features
Specialties
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Keith Thomas Corpus
- 303 N William Kumpf Blvd
- Peoria, IL
- Zip : 61605-2507
- Phone : (309) 676-5546
Second Address
- Dr. Keith Thomas Corpus
- 303 N William Kumpf Blvd
- Peoria, IL
- Zip : 61605
- Phone : (309) 676-5546
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 036.148410 | IL |
National Provider Identifier
| NPI | 1043552227 |
|---|---|
| Provider Name | Dr. Keith Thomas Corpus |
| First Address | Peoria, IL 61605-2507 |
| Second Address | Peoria, IL 61605 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/03/2013 |
| Last Update Date | 13/11/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.