1346233400 NPI number — JEFFREY A KEYSER DO

Table of content: JEFFREY A KEYSER DO (NPI 1346233400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346233400 NPI number — JEFFREY A KEYSER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEYSER
Provider First Name:
JEFFREY
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1346233400
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3421 CONCORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17402-9001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-733-4644
Provider Business Mailing Address Fax Number:
717-733-7865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
804 GRANDVIEW DR STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-466-2500
Provider Business Practice Location Address Fax Number:
717-733-7865
Provider Enumeration Date:
08/24/2005

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: 208600000X , with the licence number:  OS-004694L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 067541 . This is a "MEDICARE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA0008 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60116300 . This is a "THREE RIVERS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 020054619 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1528721 . This is a "GATEWAY PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9338687 . This is a "CIGNA PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20020200 . This is a "MERCY HEALTH PLAN PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20020196 . This is a "MERCY HEALTH PLAN PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: KE1458636 . This is a "BLUE SHIELD OF PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1458636 . This is a "KEYSTONE CENTRAL PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3101927 . This is a "AETNA USHC HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 09786390009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50009554 . This is a "CAPITAL BLUE CROSS PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0078174890004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2144133000 . This is a "KEYSTONE EAST PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 427186 . This is a "BLUE SHIELD OF PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50009561 . This is a "CAPITAL BLUE CROSS PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7107465 . This is a "AETNA USHC NONHMO" identifier . This identifiers is of the category "OTHER".




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