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Individual

WILLIAM R. KEITH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2721 DEL PRADO BLVD S, SUITE 200, CAPE CORAL, FL 33904-5781
(239) 772-3636
(239) 772-5073
Mailing address
2721 DEL PRADO BLVD S, SUITE 200, CAPE CORAL, FL 33904-5781
(239) 772-3636
(239) 772-5073

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0050381
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043671200
FL
01
08513
BCBS
FL
01
206855
AVMED
FL
01
2499169
GHI
FL
01
4198736
AETNA
FL
01
P00102099
RAILROAD MEDICARE
FL
Enumeration date
05/23/2005
Last updated
09/09/2010
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