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General NPI Number Information
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NPI Number | 1134295769
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Entity Type | Organization
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Legal Business Name | YORK PRIMARY CARE LLC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 1 BRICKYARD LN SUITE CC
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City | YORK
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State | ME
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Zip | 03909-1604
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Country | US
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Telephone | 207-361-4902
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Fax | 207-363-2502
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Provider Business Mailing Address
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Address Line | 1 BRICKYARD LN SUITE CC
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City | YORK
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State | ME
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Zip | 03909-1604
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Country | US
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Telephone | 207-361-4902
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Fax | 207-363-2505
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JOEL WILLIAM KEENAN
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Credential | M.D.
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Telephone | 207-361-4902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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