Organization
GREGORY R. KEESE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANN POOLE (BOOKKEEPER)
(208) 667-7459
Entity
Organization
Contact information
Practice address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Mailing address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316137862
PLEASE LINK TO INDIVIDUAL NPI #
ID
05
—
1740539725
—
ID
Enumeration date
09/05/2012
Last updated
06/17/2015
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