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General NPI Number Information
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NPI Number | 1427050657
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Entity Type | Individual
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Provider Name | JOHN PAUL KEENAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 2401 NW 23RD ST SUITE 1A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-2442
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Country | US
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Telephone | 405-522-7176
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Fax | 405-530-3245
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Provider Business Mailing Address
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Address Line | 5312 ROCKPORT WAY
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City | EDMOND
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State | OK
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Zip | 73013-8639
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Country | US
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Telephone | 405-844-6483
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Fax | 405-844-6483
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 20549
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License Number State | OK
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