MEDICARE: ROGER CLIFFORD KEEVER PA

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	363AM0700X	Medical Physician Assistant	103238	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	103238	OTHER	NC	NC MEDICAL BOARD PA LICEN

General Provider Information

NPI Number	:	1669508024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER CLIFFORD KEEVER PA

Provider Business Mailing Address
First Line	:	2345 MORGANTON BLVD SW
Second Line	:	P.O. BOX 400
City	:	LENOIR
State	:	NC
Zip	:	28645-4973
Country	:	US
Telephone Number	:	828-426-8433
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 MORGANTON BLVD SW
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-4973
Country	:	US
Telephone Number	:	828-426-8433
Fax Number	:

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/18/2024

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Directions to “ ROGER CLIFFORD KEEVER PA” Practice Location

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