Provider Demographics
NPI:1073592465
Name:TRUE, PETER KEENE (M D)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:KEENE
Last Name:TRUE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CHILD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32214-5005
Mailing Address - Country:US
Mailing Address - Phone:904-542-3473
Mailing Address - Fax:904-542-7662
Practice Address - Street 1:2080 CHILD ST
Practice Address - Street 2:U. S. NAVAL HOSPITAL JACKSONVILLE NAS JAX
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-5005
Practice Address - Country:US
Practice Address - Phone:904-542-3473
Practice Address - Fax:904-542-7662
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010418932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry