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General NPI Number Information
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NPI Number | 1073715447
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Entity Type | Organization
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Legal Business Name | DAVID K. KEITH DO LLC
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 28 CONSERVATORY DR SUITE B
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City | BARBERTON
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State | OH
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Zip | 44203-4275
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Country | US
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Telephone | 330-861-4100
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Fax | 330-861-0987
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Provider Business Mailing Address
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Address Line | 28 CONSERVATORY DR SUITE B
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City | BARBERTON
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State | OH
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Zip | 44203-4275
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Country | US
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Telephone | 330-861-4100
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Fax | 330-861-0987
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID KEVIN KEITH
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Credential | D.O
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Telephone | 330-861-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34-007169
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License Number State | OH
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