Individual
KEITH E MACKSOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1817 OLD LOUISQUISSET PIKE, LINCOLN, RI 02865-4516
(401) 727-2443
(401) 729-3476
Mailing address
1817 OLD LOUISQUISSET PIKE, LINCOLN, RI 02865-4516
(401) 727-2443
(401) 729-3476
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA24719
RI
Other
Enumeration date
02/22/2006
Last updated
10/31/2007
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