Provider Demographics
NPI:1386610111
Name:KEEHN, MICHAEL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:KEEHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WHITE WAY ST
Mailing Address - Street 2:
Mailing Address - City:NETAWAKA
Mailing Address - State:KS
Mailing Address - Zip Code:66516-9323
Mailing Address - Country:US
Mailing Address - Phone:785-933-2000
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE WAY ST
Practice Address - Street 2:
Practice Address - City:NETAWAKA
Practice Address - State:KS
Practice Address - Zip Code:66516-9323
Practice Address - Country:US
Practice Address - Phone:785-933-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0424501207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100321430DMedicaid
KSP00346138OtherRAILROAD MEDICARE
KSG72800Medicare UPIN
KS100321430DMedicaid