1376878181 NPI number — MICHAEL JOHN O'KEEFE JR. NP-C

Table of content: MICHAEL JOHN O'KEEFE JR. NP-C (NPI 1376878181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376878181 NPI number — MICHAEL JOHN O'KEEFE JR. NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'KEEFE
Provider First Name:
MICHAEL
Provider Middle Name:
JOHN
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
NP-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376878181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 MDG, UNIT 3215
Provider Second Line Business Mailing Address:
RAMSTEIN AB, APO AE
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
09094
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-479-2273
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
86 MDG, UNIT 3215
Provider Second Line Business Practice Location Address:
RAMSTEIN AB, APO AE 09094
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
09094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-479-2733
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  043883-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)