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Individual

DAVID K. KESHEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C,

Contact information

Practice address
700 BOB O LINK DRIVE, LEXINGTON, KY 40504
(859) 258-8575
(859) 258-8562
Mailing address
700 BOB O LINK DRIVE, LEXINGTON, KY 40504
(859) 258-8575
(859) 258-8562

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA213
KY
363AM0700X
Medical Physician Assistant
PA213
KY
363AS0400X
Surgical Physician Assistant
PA213
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37903705
MEDICAID LAB GROUP#
KY
01
4000501
MEDICARE LAB GROUP#
KY
05
95002135
KY
01
CB5773
RR MEDICARE GROUP#
GA
01
P00213321
RR MEDICARE PIN#
GA
Enumeration date
10/04/2006
Last updated
11/02/2007
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