# KEEGO FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1891121901
- **Authorized official:** MS. HEATHER DICKENSON (ADMINISTRATOR)
- **Authorized official phone:** (248) 977-4516

## Contact information

- **Practice address:** 3435 ORCHARD LAKE RD, KEEGO HARBOR, MI 48320-1315
- **Practice address phone:** (248) 977-4516
- **Practice address fax:** (248) 977-4549
- **Mailing address:** 3435 ORCHARD LAKE RD, KEEGO HARBOR, MI 48320-1315
- **Mailing address phone:** (248) 977-4516
- **Mailing address fax:** (248) 977-4549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301069223 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2013
- **Last updated:** 09/20/2013