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NPI Code Detail

MEDICARE: DR. TERRY KEIFER MD

MEDICARE: DR. TERRY KEIFER 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
12085B0100XBody Imaging Physician036-105676IL
22085R0202XDiagnostic Radiology PhysicianC54596CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C54596OTHERCAMEDICAL STATE LICENSE

General Provider Information

NPI Number : 1528095999
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY KEIFER MD
Provider Business Mailing Address
First Line : 3400 DATA DR
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-7956
Country : US
Telephone Number : 916-861-1486
Fax Number :
Provider Business Practice Location Address
First Line : 2020 PALOMINO LN STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4894
Country : US
Telephone Number : 702-759-8600
Fax Number : 702-384-1815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 08/18/2021

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Directions to “ DR. TERRY KEIFER MD” Practice Location

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