Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 66959 | GA |
Y | 207X00000X | Orthopaedic Surgeon | 66959 | GA |
N | 208D00000X | General Practice Physician | OS016409 | PA |
NPI | 1033378963 |
---|---|
Provider Name | Dr. Kevin D Keith |
First Address | Edinboro, PA 16412-2363 |
Second Address | Fpo, AP 96362-9636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 03/05/2019 |