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NPI Code Detail

MEDICARE: DR. PAUL W KEOUGH

MEDICARE: DR. PAUL W KEOUGH
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
1207V00000XObstetrics & Gynecology Physician54115MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1J06133OTHERMABCBS
2139144OTHERCIGNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
413174OTHERMAHPHC
52159044OTHERTUTS USFHP
6708695OTHERTUFTS

General Provider Information

NPI Number : 1366426348
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL W KEOUGH
Provider Business Mailing Address
First Line : 15 WOODBRIDGE RD
Second Line :
City : HINGHAM
State : MA
Zip : 02043-3144
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 135 WEBSTER ST
Second Line :
City : HANOVER
State : MA
Zip : 02339-1200
Country : US
Telephone Number : 781-878-7020
Fax Number : 781-871-3590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 02/18/2015

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