Organization
AFFILIATED NEUROLOGISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RANDALL KEANE M.D. (MEMBER)
(208) 746-3320
Entity
Organization
Contact information
Practice address
338 6TH ST, SUITE 102, LEWISTON, ID 83501-2419
(208) 746-3320
(208) 746-8717
Mailing address
338 6TH ST, SUITE 102, LEWISTON, ID 83501-2419
(208) 746-3320
(208) 746-8717
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
M7728
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7088867
—
WA
Enumeration date
01/19/2007
Last updated
08/22/2020
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