Provider Demographics
NPI:1528135571
Name:OZANNE, KEITH ERNEST (DC)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ERNEST
Last Name:OZANNE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 W BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951
Mailing Address - Country:US
Mailing Address - Phone:215-536-2225
Mailing Address - Fax:215-536-6516
Practice Address - Street 1:1226 W BROAD STREET
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951
Practice Address - Country:US
Practice Address - Phone:215-536-2225
Practice Address - Fax:215-536-6516
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004665L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1240450Medicaid
PA16135OtherHEALTH PARTNERS
PA653901OtherBCBS
PA0775780000OtherKEYSTONE
PA0845855OtherUS HEALTHCARE AETNA
PA843189OtherBCBS
PAP1581257OtherOXFORD
PA16135OtherHEALTH PARTNERS