Organization
KEITH F. KORVER, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH FORREST KORVER M.D. (PRESIDENT)
(707) 569-7860
Entity
Organization
Contact information
Practice address
5196 HILL RD E, STE 202, LAKEPORT, CA 95453-6360
(707) 263-1777
(707) 263-8137
Mailing address
3510 UNOCAL PL STE 207, SANTA ROSA, CA 95403-0918
(707) 569-7860
(707) 545-5408
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090986
—
CA
Enumeration date
05/31/2006
Last updated
07/15/2021
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