MEDICARE: KEITH A ROUSE DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	SC004509L	PA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	885	GA

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

General Provider Information

NPI Number	:	1558374124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH A ROUSE DPM

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6969

Provider Business Practice Location Address
First Line	:	210 JPM RD STE 300
Second Line	:
City	:	LEWISBURG
State	:	PA
Zip	:	17837-9367
Country	:	US
Telephone Number	:	570-524-4446
Fax Number	:	570-768-4623

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	03/05/2026

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Directions to “ KEITH A ROUSE DPM” Practice Location

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