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NPI 1265431449

NPI 1265431449 : CHRISTOPHER KEANE MD : BEND, OR

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General NPI Number Information
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    NPI Number           |    1265431449
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER KEANE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/19/2005
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    Last Update Date     |    10/15/2024
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Provider Practice Location Address
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    Address Line         |    2650 NE COURTNEY DR 
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    City                 |    BEND
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    State                |    OR
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    Zip                  |    97701-7636
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    Country              |    US
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    Telephone            |    541-647-5200
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    Fax                  |    541-647-5225
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Provider Business Mailing Address
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    Address Line         |    2650 NE COURTNEY DR 
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    City                 |    BEND
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    State                |    OR
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    Zip                  |    97701-7636
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    Country              |    US
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    Telephone            |    541-647-5200
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    Fax                  |    541-647-5225
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    A75168
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MD28678
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    License Number State |    OR
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