MEDICARE: JAMES J KEESLING

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	HMEL11183	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	HMEL11183	OTHER	OH	ORCB-STATE LICENSE

General Provider Information

NPI Number	:	1245509553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES J KEESLING

Provider Business Mailing Address
First Line	:	PO BOX 14385
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45250-0385
Country	:	US
Telephone Number	:	513-542-4900
Fax Number	:	513-542-4900

Provider Business Practice Location Address
First Line	:	1109 ALFRED ST
Second Line	:	101B
City	:	CINCINNATI
State	:	OH
Zip	:	45214-1705
Country	:	US
Telephone Number	:	513-542-4900
Fax Number	:	513-542-4900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2011
Last Update Date	:	12/16/2011

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