Provider Demographics
NPI:1316926264
Name:KEYES, KATHLEEN J (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:J
Last Name:KEYES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1236 E RUSHOLME ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2473
Mailing Address - Country:US
Mailing Address - Phone:563-324-2992
Mailing Address - Fax:563-888-0499
Practice Address - Street 1:1236 E RUSHOLME ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2473
Practice Address - Country:US
Practice Address - Phone:563-324-2992
Practice Address - Fax:563-888-0499
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2024-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA32016207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060044666OtherMEDICARE RAILROAD
IA0154344Medicaid
ILL60949Medicare PIN
IA40420Medicare PIN