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Individual

DUANE LESLIE KEITEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
517 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 341-5030
(859) 578-7551
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
35.083505
OH
207K00000X
Allergy & Immunology Physician
Primary
37692
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0708303
MEDICARE PTAN
KY
05
64067234
KY
Enumeration date
10/26/2005
Last updated
11/01/2023
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