Individual
KEIFFER PAUL SUDDETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
907 LINCOLN HWY W, NEW HAVEN, IN 46774-2141
(260) 493-3736
(260) 749-7947
Mailing address
10035 NORTHBROOK VALLEY DR APT 1, FORT WAYNE, IN 46825-2380
(317) 440-2916
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
45020981A
IN
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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