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NPI Code Detail

MEDICARE: KEITH J HARKINS M.D.

MEDICARE: KEITH J HARKINS M.D.
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
1207P00000XEmergency Medicine Physician35061943OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000552748OTHEROHANTHEM BCBS
2000000552749OTHEROHANTHEM BCBS PIKE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265410716
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH J HARKINS M.D.
Provider Business Mailing Address
First Line : 4750 HEMPSTEAD STATION DR
Second Line :
City : KETTERING
State : OH
Zip : 45429-5164
Country : US
Telephone Number : 800-875-0136
Fax Number :
Provider Business Practice Location Address
First Line : 1275 N HIGH ST
Second Line :
City : HILLSBORO
State : OH
Zip : 45133-8273
Country : US
Telephone Number : 937-393-6100
Fax Number : 937-619-4150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 11/10/2011

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