Provider Demographics
NPI:1063770949
Name:KEANE, MARGARET MARY (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:KEANE
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:WILLIS KNIGHTON PHYSICIAN NETWORK
Mailing Address - Street 2:1202 LOUISIANA AVENUE
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3910
Mailing Address - Country:US
Mailing Address - Phone:318-212-8951
Mailing Address - Fax:318-212-6752
Practice Address - Street 1:2508 BERT KOUNS INDUSTRIAL LOOP STE 320
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3167
Practice Address - Country:US
Practice Address - Phone:318-212-5990
Practice Address - Fax:318-212-5887
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2021-06-17
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Provider Licenses
StateLicense IDTaxonomies
WI64342-20208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics