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General NPI Number Information
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NPI Number | 1336134063
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Entity Type | Individual
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Provider Name | TIMOTHY E KEANE D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2403 ALLISON RD
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City | BEAUFORT
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State | SC
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Zip | 29902-5923
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Country | US
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Telephone | 843-524-1078
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Fax | 843-524-1137
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Provider Business Mailing Address
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Address Line | 9 BURCHMYER DR
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City | BEAUFORT
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State | SC
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Zip | 29907-1709
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Country | US
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Telephone | 843-524-1078
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Fax | 843-524-1137
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 02240
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License Number State | SC
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