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NPI 1689769457

NPI 1689769457 : DAVID K. KESHEIMER P.A.-C, : LEXINGTON, KY

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General NPI Number Information
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    NPI Number           |    1689769457
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID K. KESHEIMER P.A.-C,
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/04/2006
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    Last Update Date     |    11/02/2007
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Provider Practice Location Address
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    Address Line         |    700 BOB O LINK DRIVE 
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    City                 |    LEXINGTON
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    State                |    KY
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    Zip                  |    40504
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    Country              |    US
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    Telephone            |    859-258-8575
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    Fax                  |    859-258-8562
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Provider Business Mailing Address
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    Address Line         |    700 BOB O LINK DRIVE 
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    City                 |    LEXINGTON
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    State                |    KY
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    Zip                  |    40504
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    Country              |    US
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    Telephone            |    859-258-8575
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    Fax                  |    859-258-8562
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA213
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    PA213
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    License Number State |    KY
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Taxonomy #3
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    Taxonomy Code        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    PA213
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    License Number State |    KY
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