Healthcare Provider Details

I. General information

NPI: 1730122102
Provider Name (Legal Business Name): CRAIG KEEVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5507 W WALSH LN STE 101
ROGERS AR
72758-9007
US

IV. Provider business mailing address

5507 W WALSH LN STE 101
ROGERS AR
72758-9007
US

V. Phone/Fax

Practice location:
  • Phone: 479-544-9432
  • Fax: 479-544-9443
Mailing address:
  • Phone: 479-544-9432
  • Fax: 479-544-9443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE3170
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: