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General NPI Number Information
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NPI Number | 1710216726
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Entity Type | Individual
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Provider Name | BRIAN P KEEHN D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 1919 E THOMAS RD DEPT OF RADIOLOGY
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City | PHOENIX
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State | AZ
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Zip | 85016-7710
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Country | US
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Telephone | 602-933-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 E THOMAS RD DEPT OF RADIOLOGY
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City | PHOENIX
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State | AZ
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Zip | 85016-7710
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Country | US
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Telephone | 602-933-1222
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Fax |
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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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 006718
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License Number State | AZ
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