Basic Information
| Provider Information | |||||||||
| NPI: | 1144317140 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUD | ||||||||
| FirstName: | KEITH | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | DARTMOUTH-HITCHCOCK MEDICAL CENTER | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037561000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036539850 | ||||||||
| FaxNumber: | 6036500910 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | DARTMOUTH-HITCHCOCK MEDICAL CENTER | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037561000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036539850 | ||||||||
| FaxNumber: | 6036500910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 06/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | 35-084751 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | 2080S0010X | 35-084751 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | Sports Medicine | 208000000X | 15035 | NH | Y | Allopathic & Osteopathic Physicians | Pediatrics | 2080A0000X | 15035 | NH | N | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | 2080S0010X | 15035 | NH | N | Allopathic & Osteopathic Physicians | Pediatrics | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 30209933 | 05 | NH | MEDICAID | 1018270 | 05 | VT | MEDICAID | 2503553 | 05 | OH | MEDICAID |