Individual
KEITH E ROCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4110 E FOREST GLEN AVE, LEESBURG, IN 46538-9552
(574) 253-1901
Mailing address
4110 E FOREST GLEN AVE, LEESBURG, IN 46538-9552
(574) 253-1901
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01039062A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082191
BC BS
IN
01
—
000000192998
BC BS
IN
01
—
036123721
MEDICAID
IL
05
—
200006410A
—
IN
01
—
300064852
RAILROAD MEDICARE
IN
01
—
300127023
RAILROAD MEDICARE
IN
01
—
609080
MEDICARE
IL
01
—
609330
MEDICARE
IL
Enumeration date
07/19/2005
Last updated
08/02/2023
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