Provider Demographics
NPI:1720050057
Name:KEYS, MARC S (DPM)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:S
Last Name:KEYS
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:823 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2401
Mailing Address - Country:US
Mailing Address - Phone:517-788-7760
Mailing Address - Fax:517-788-7730
Practice Address - Street 1:823 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2401
Practice Address - Country:US
Practice Address - Phone:517-788-7760
Practice Address - Fax:517-788-7730
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2016-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIMK000761213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
03856OtherPARAMOUNT
1006470OtherJACKSON HEALTH PLAN
480015360OtherRAIL ROAD MR
MI3296294Medicaid
107211OtherPREF CHOICES
4854613330OtherBCBS
200000004415OtherPHP
7165081OtherCIGNA
C5010OtherMCARE
MI1238522Medicaid
MI0P24230001OtherPTAN
101452OtherGREAT LAKES HEALTH PLAN
2756OtherHEALTH PLAN OF MI
4854613330OtherBCBS
C5010OtherMCARE
107211OtherPREF CHOICES