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NPI Code Detail

MEDICARE: DR. ROXANNE R KEENE MD

MEDICARE: DR. ROXANNE R KEENE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician125051588IL
2207X00000XOrthopaedic Surgery Physician12033ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184661118
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROXANNE R KEENE MD
Provider Business Mailing Address
First Line : 1301 15TH AVE. W
Second Line : MERCY MEDICAL CENTER
City : WILLISTON
State : ND
Zip : 58801-3821
Country : US
Telephone Number : 701-774-7400
Fax Number :
Provider Business Practice Location Address
First Line : 1213 15TH AVE. W
Second Line :
City : WILLISTON
State : ND
Zip : 58801-3821
Country : US
Telephone Number : 701-572-7651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 11/01/2012

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Directions to “ DR. ROXANNE R KEENE MD” Practice Location

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