Individual
DR. JEFFREY P KECK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 334-4822
Mailing address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
049765
GA
207L00000X
Anesthesiology Physician
Primary
2012004815
MO
207L00000X
Anesthesiology Physician
43374
KY
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
049765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100115960
—
KY
Enumeration date
01/25/2006
Last updated
04/05/2016
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