Provider Demographics
NPI:1124094222
Name:KEENAN, BARBARA F (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:F
Last Name:KEENAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S LINCOLN AVE
Mailing Address - Street 2:LEBANON VA MEDICAL CENTER
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7529
Mailing Address - Country:US
Mailing Address - Phone:717-272-6621
Mailing Address - Fax:717-228-5926
Practice Address - Street 1:1700 S LINCOLN AVE
Practice Address - Street 2:LEBANON VA MEDICAL CENTER
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:717-228-5926
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067210L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017384120005Medicaid
PA097686OtherMEDICARE LEGACY GROUP#
PA142860OtherHIGHMARK BCBS#
PA50058847OtherCAPITAL BCBS#
PAP00303698OtherRAILROAD MEDICARE#
G85386Medicare UPIN
PAP00303698OtherRAILROAD MEDICARE#