Individual
KERRY KEAFFABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 E COUNTRY LN, SHIPSHEWANA, IN 46565-8568
(260) 768-4141
(260) 768-7295
Mailing address
450 E COUNTRY LN, SHIPSHEWANA, IN 46565-8568
(260) 768-4141
(260) 768-7295
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033783A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359990
—
IN
Enumeration date
06/21/2006
Last updated
03/18/2024
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