Provider Demographics
NPI:1336126580
Name:KEYS, BRIAN C (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:C
Last Name:KEYS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1443
Mailing Address - Country:US
Mailing Address - Phone:317-770-5861
Mailing Address - Fax:317-770-5867
Practice Address - Street 1:355 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1443
Practice Address - Country:US
Practice Address - Phone:317-770-5861
Practice Address - Fax:317-770-5867
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002863207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00191367Medicare PIN
I14513Medicare UPIN