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Individual

DR. KATHRYN S. KEITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1167 A HWY 554, EL RITO, NM 87530
(505) 581-0033
(505) 581-0034
Mailing address
PO BOX 805, EL RITO, NM 87530-0805
(505) 581-0033
(505) 581-0034

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
74-187
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18756
PRESBYTERIAN
NM
05
1883
NM
01
32DO988162
CLIA
NM
01
3642
CIGNA
NM
01
89791
HEALTH PARTNERS
NM
01
9386
BLUE CROSS BLUE SHIELD
NM
Enumeration date
09/07/2005
Last updated
07/08/2007
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