Organization
KEITH F. KORVER, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH FORREST KORVER M.D. (PRESIDENT)
(707) 569-7860
Entity
Organization
Contact information
Practice address
721 RIVER DR, STE A, FORT BRAGG, CA 95437-5402
(707) 573-6166
(707) 573-6165
Mailing address
3510 UNOCAL PL STE 207, SANTA ROSA, CA 95403-0918
(707) 569-7860
(707) 545-5408
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090981
—
CA
Enumeration date
05/24/2006
Last updated
07/15/2021
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