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Organization
PAUL KEANE
Active
Organization
PAUL KEANE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL J KEANE DPM (PODIATRIST)
(252) 985-1371
Entity
Organization
Contact information
Practice address
1855 E MAIN ST, STE 14, TMB 151, SPARTANBURG, SC 29307-2309
(252) 985-1371
Mailing address
P O BOX 7396, ROCKY MOUNT, NC 27804-4837
(252) 985-1371
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
57
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001P
—
SC
01
—
P00351117
RAILROAD MEDICARE
SC
Enumeration date
03/20/2007
Last updated
07/03/2008
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