Individual
DR. DENNIS KEESAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
83 PROGRESS PKWY, MARYLAND HEIGHTS, MO 63043-3701
(314) 434-8174
Mailing address
16347 WILSON FARM DR, CHESTERFIELD, MO 63005-4542
(636) 532-5280
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R6496
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME24072
LICENSE
FL
01
—
P00353235
RR MEDICARE
MO
01
—
R6496
LICENSE
MO
Enumeration date
07/26/2006
Last updated
11/13/2011
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