Individual
JAMES ADAM KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845-1714
(260) 425-6030
(260) 458-6028
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01085024A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102422515
ANTHEM PTAN
IN
05
—
300048324
—
IN
Enumeration date
03/31/2017
Last updated
04/14/2025
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