Provider Demographics
NPI:1366423881
Name:OKEEFE, PATRICK JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:OKEEFE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1421 LUISA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4073
Mailing Address - Country:US
Mailing Address - Phone:505-983-4225
Mailing Address - Fax:505-983-7256
Practice Address - Street 1:1421 LUISA ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4073
Practice Address - Country:US
Practice Address - Phone:505-983-4225
Practice Address - Fax:505-983-7256
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V08653Medicare UPIN