Keith, Jack P
Keith, Jack P is an sole proprietor health care provider with primary practice located at 45 Golder St , Lewiston ME 04240-6033. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Keith, Jack P can be contacted via phone (207) 755-3715.Contact Information
Primary practice address
45 Golder St
Lewiston ME 04240-6033
Phone: (207) 755-3715
Fax: (207) 755-3728
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 013034 | Maine |
Profile Details
| NPI number | 1750393203 |
|---|---|
| LBN Legal business name | Keith, Jack P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Apr 26th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750393203 | NPPES |
| Other | 050029135 | RAILROAD MEDICARE | |
| Other | 002622 | RAILROAD MEDICARE | |
| MEDICAID | 316040099 | RAILROAD MEDICARE |
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