Healthcare Provider Details

I. General information

NPI: 1386697548
Provider Name (Legal Business Name): MICHAEL JOSEPH KEEFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 MCAULEY BLVD SUITE 375
OKLAHOMA CITY OK
73120-9391
US

IV. Provider business mailing address

4300 W MEMORIAL RD
OKLAHOMA CITY OK
73120-8304
US

V. Phone/Fax

Practice location:
  • Phone: 405-751-4343
  • Fax: 405-751-4346
Mailing address:
  • Phone: 405-751-4343
  • Fax: 405-751-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number13774
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: