# GREGORY R. KEESE, M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740539725
- **Authorized official:** PATRICIA ANN POOLE (BOOKKEEPER)
- **Authorized official phone:** (208) 667-7459

## Contact information

- **Practice address:** 1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
- **Practice address phone:** (208) 667-7459
- **Practice address fax:** (208) 667-2631
- **Mailing address:** 1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
- **Mailing address phone:** (208) 667-7459
- **Mailing address fax:** (208) 667-2631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | ID | Yes |

## Other

- **Enumeration date:** 09/05/2012
- **Last updated:** 06/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1316137862 | PLEASE LINK TO INDIVIDUAL NPI \# | ID |
| 05 | — | 1740539725 | — | ID |