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General NPI Number Information
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NPI Number | 1710012554
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Entity Type | Individual
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Provider Name | KEITH WAYNE BARON M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 168 S HOWELL ST
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City | HILLSDALE
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State | MI
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Zip | 49242-2040
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Country | US
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Telephone | 517-437-4454
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Fax |
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Provider Business Mailing Address
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Address Line | 1371 BANKERS RD
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City | HILLSDALE
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State | MI
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Zip | 49242-8641
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Country | US
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Telephone | 517-439-5835
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Fax | 517-439-5835
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | KB043923
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License Number State | MI
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