Provider Demographics
NPI:1891767372
Name:BARKOW, KEITH C (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:C
Last Name:BARKOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:226 US HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-9713
Mailing Address - Country:US
Mailing Address - Phone:574-825-8068
Mailing Address - Fax:574-825-4873
Practice Address - Street 1:851 PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-9334
Practice Address - Country:US
Practice Address - Phone:574-537-0521
Practice Address - Fax:574-537-1217
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048887A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200242310Medicaid
IN184520AAMedicare ID - Type Unspecified
IN200242310Medicaid