Individual
DR. GREGORY R KEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Mailing address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
M11774
ID
174400000X
Specialist
TL-3904
ID
207X00000X
Orthopaedic Surgery Physician
Primary
M-11774
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083729438
OSSM ORGANIZATION LINKED TO THIS NPI
ID
01
—
1740539725
NEW ORGANIZATION NPI LINKED TO THIS INDIVIDUAL NPI
ID
01
—
P01315338
PALMETTO GBA
ID
Enumeration date
07/31/2007
Last updated
04/26/2021
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