Healthcare Provider Details

I. General information

NPI: 1508851791
Provider Name (Legal Business Name): TIMOTHY G KEENAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 PORTSMOUTH AVE STE A201
STRATHAM NH
03885-4411
US

IV. Provider business mailing address

118 PORTSMOUTH AVE STE A201
STRATHAM NH
03885-4411
US

V. Phone/Fax

Practice location:
  • Phone: 603-379-2844
  • Fax: 603-379-2860
Mailing address:
  • Phone: 603-379-2844
  • Fax: 603-379-2860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13165
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: