Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 3381 | SD |
NPI | 1023118619 |
---|---|
Provider Name | James Michael Keegan |
First Address | Rapid City, SD 57701-6025 |
Second Address | Rapid City, SD 57701-6025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 30/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4994439 | WELLMARK (01) | SD |
6002254 | (05) | SD |
9172878 | DAKOTACARE (01) | SD |
D71728 | (02) | |
P00261629 | RR MEDICARE (01) | SD |