Individual
MARK K KEOHANE
Active
Individual
MARK K KEOHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34653
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122683
HEALTHLINK
—
01
—
18883
BLUE CROSS BLUE SHIELD
—
01
—
2253V3458
GHP/ADVANTRA
—
01
—
351240001
CIGNA DMERC
—
01
—
4061116
AETNA
—
01
—
43177
CMR
—
01
—
4434V6097
HEALTHCARE USA
—
01
—
900094
UHC
—
01
—
9043
EXCLUSIVE CHOICE
—
01
—
SP10133
CIGNA
—
Enumeration date
05/23/2005
Last updated
03/01/2012
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