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Individual

PAUL JOSEPH KEANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
267 W RIDGE DR, BRYSON CITY, NC 28713-7602
(828) 488-8200
(828) 488-8221
Mailing address
PO BOX 1730, BRYSON CITY, NC 28713-1730
(828) 488-8200
(828) 488-8221

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
57
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0802Q
BCBS
01
08153
BCBS
01
225158
PARTNERS
05
890802Q
NC
05
8908153
NC
01
P00102841
MEDICARE RR
Enumeration date
09/12/2006
Last updated
05/23/2008
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