Individual
DAVID L. KEEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W 5TH ST, LONDON, KY 40741-2112
(606) 864-4040
(606) 864-3500
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7840
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
26392
KY
207RI0011X
Interventional Cardiology Physician
26392
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060086348
RR MEDICARE PIN#
GA
01
—
36000818
ASC MEDICAID GROUP#
KY
01
—
37903705
MEDICAID LAB GROUP#
KY
01
—
4000501
MEDICARE GROUP NUMBER
KY
05
—
64263924
—
KY
01
—
ASC 1019
ASC MEDICARE GROUP#
KY
01
—
CB5773
RR MEDICARE GROUP#
GA
Enumeration date
07/14/2006
Last updated
05/02/2019
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