Individual
KEITH ALEX RASMUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
605 SW 27TH ST, EL RENO, OK 73036-5928
(405) 295-2200
(405) 295-2178
Mailing address
605 SW 27TH ST, EL RENO, OK 73036-5928
(405) 295-2200
(405) 295-2178
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1725
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734110B
—
OK
Enumeration date
04/18/2008
Last updated
01/12/2016
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