1457575011 NPI number — DR. SIOBHAN O'KEEFE MB,BCH,BAO

Table of content: DR. SIOBHAN O'KEEFE MB,BCH,BAO (NPI 1457575011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457575011 NPI number — DR. SIOBHAN O'KEEFE MB,BCH,BAO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'KEEFE
Provider First Name:
SIOBHAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MB,BCH,BAO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'CONNOR
Provider Other First Name:
SIOBHAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MB, BCH, BAO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457575011
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13001 E. 17TH PLACE
Provider Second Line Business Mailing Address:
UNIVERSITY OF COLORADO GME
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80045-2581
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-724-2393
Provider Business Mailing Address Fax Number:
720-777-7324

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13001 E. 17TH PLACE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF COLORADO GME
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045-2581
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-724-2393
Provider Business Practice Location Address Fax Number:
720-777-7324
Provider Enumeration Date:
04/12/2007

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: 207R00000X , with the licence number:  2010-00442 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 2010-00442 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5915309 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1589U . This is a "BCBSNC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".