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General NPI Number Information
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NPI Number | 1942277751
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Entity Type | Individual
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Provider Name | DOUGLAS KEEHN DO
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Gender | Male
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 1604 MADISON AVE
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City | FORT ATKINSON
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State | WI
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Zip | 53538-3101
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Country | US
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Telephone | 920-568-6596
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | FORT ATKINSON
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State | WI
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Zip | 53538-0249
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Country | US
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Telephone | 920-563-4466
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 43692
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License Number State | WI
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