Individual
DR. KEITH R LAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14800 S WESTERN AVE, MOORE, OK 73170-7112
(405) 515-0330
(405) 307-5662
Mailing address
PO BOX 1330, NORMAN, OK 73070-1330
(405) 307-6668
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3364
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065040C
—
OK
05
—
100065040D
—
OK
01
—
4968390000
DME NUMBER
OK
Enumeration date
10/06/2005
Last updated
06/30/2021
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