Organization
ST. MARY'S ANESTHESIA ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK P KEITH M. D. (PRESIDENT)
(207) 755-3715
Entity
Organization
Contact information
Practice address
93 CAMPUS AVE, LEWISTON, ME 04240-6030
(207) 755-3715
(207) 755-3728
Mailing address
PO BOX 1823, LEWISTON, ME 04241-1823
(207) 755-3715
(207) 755-3728
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125530100
—
ME
Enumeration date
11/29/2006
Last updated
04/26/2012
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