Healthcare Provider Details

I. General information

NPI: 1831133255
Provider Name (Legal Business Name): DAWN MARIE O'KEEFE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 TUSCAN AVE
HATTIESBURG MS
39401-5461
US

IV. Provider business mailing address

PO BOX 8419
BILOXI MS
39535-8087
US

V. Phone/Fax

Practice location:
  • Phone: 601-543-0221
  • Fax: 601-543-0201
Mailing address:
  • Phone: 228-388-5714
  • Fax: 228-388-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1186
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: