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General NPI Number Information
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NPI Number | 1184627689
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE OF KEOKUK PC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1603 MORGAN ST STE 2
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City | KEOKUK
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State | IA
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Zip | 52632-3433
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Country | US
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Telephone | 319-524-6274
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Fax | 319-524-9068
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Provider Business Mailing Address
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Address Line | 1603 MORGAN ST STE 2
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City | KEOKUK
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State | IA
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Zip | 52632-3433
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Country | US
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Telephone | 319-524-6274
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Fax | 319-524-9068
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Authorized Official
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Title or Position | CMIS
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Name | MRS. BRENDA J BEST
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Credential |
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Telephone | 319-524-6274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 21526
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License Number State | IA
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