Keohane, Mark K

Keohane, Mark K is an individual health care provider with primary practice located at 9323 Phoenix Village Pkwy , O Fallon MO 63366-4281. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Keohane, Mark K can be contacted via phone (636) 561-5030.

Contact Information

Primary practice address
9323 Phoenix Village Pkwy O Fallon MO 63366-4281
Phone: (636) 561-5030
Fax: (636) 561-5033
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 34653 Missouri

Profile Details

NPI number 1710980750
LBN Legal business name Keohane, Mark K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Mar 1st, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710980750 NPPES
Other 4061116 AETNA
Other 43177 AETNA
Other 18883 AETNA
Other 122683 AETNA
Other 351240001 AETNA
Other 900094 AETNA
Other 4434V6097 AETNA
Other 9043 AETNA
Other 2253V3458 AETNA
Other SP10133 AETNA

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