Provider Demographics
NPI:1124826565
Name:PALMER, KEELEY
Entity type:Individual
Prefix:
First Name:KEELEY
Middle Name:
Last Name:PALMER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 E HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-6637
Mailing Address - Country:US
Mailing Address - Phone:405-223-6341
Mailing Address - Fax:
Practice Address - Street 1:1328 E HILLS DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-6637
Practice Address - Country:US
Practice Address - Phone:405-223-6341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist