Healthcare Provider Details

I. General information

NPI: 1811001274
Provider Name (Legal Business Name): KATHERINE GC KEECH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR DEPT OF ANESTHESIA
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR DEPT OF ANESTHESIA
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-2633
  • Fax: 319-356-2940
Mailing address:
  • Phone: 319-356-2633
  • Fax: 319-356-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2011019229
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number2011019229
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number40973
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number40973
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: