Individual
DR. TYLER KEENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 482-5060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35770
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000005545
—
IN
Enumeration date
06/10/2013
Last updated
10/30/2018
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