Individual
DR. KEITH E BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7250 CLEARVISTA DR, SUITE 260, INDIANAPOLIS, IN 46256
(317) 621-1690
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01061244A
IN
207RI0200X
Infectious Disease Physician
Primary
01061244A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200910800
—
IN
01
—
P01549399
MEDICARE RAILROAD PTAN
IN
Enumeration date
04/23/2007
Last updated
06/14/2021
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