MEDICARE: JAMES MICHAEL KEEGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	3381	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00261629	OTHER	SD	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4994439	OTHER	SD	WELLMARK
2	9172878	OTHER	SD	DAKOTACARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023118619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MICHAEL KEEGAN MD

Provider Business Mailing Address
First Line	:	4940 5TH ST
Second Line	:	SUITE 1B
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6025
Country	:	US
Telephone Number	:	605-342-8329
Fax Number	:

Provider Business Practice Location Address
First Line	:	4940 5TH ST
Second Line	:	SUITE 1B
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6025
Country	:	US
Telephone Number	:	605-342-8329
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/30/2013

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