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Individual

DR. SHAYNE S KEDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
24 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-3737
Mailing address
610 SUMPTER DR, FARMINGTON, MO 63640-7749
(573) 747-3365

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2001016005
MO
208VP0000X
Pain Medicine Physician
Primary
2001016005
MO

Other

Enumeration date
02/10/2006
Last updated
12/17/2014
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