MEDICARE: DR. KEITH COURTNEY DO

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	2084P0800X	Psychiatry Physician	1254	NV

General Provider Information

NPI Number	:	1831251107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH COURTNEY DO

Provider Business Mailing Address
First Line	:	840 S RANCHO DR # 4-330
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3837
Country	:	US
Telephone Number	:	702-460-5906
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 S RANCHO DR # 4-330
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3837
Country	:	US
Telephone Number	:	702-460-5906
Fax Number	:

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/08/2007

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