Basic Information
| Provider Information | |||||||||
| NPI: | 1417023136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARVIE | ||||||||
| FirstName: | KEITH | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4253 MONTGOMERY | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058304463 | ||||||||
| FaxNumber: | 5058304465 | ||||||||
| Practice Location | |||||||||
| Address1: | 5400 GIBSON SE | ||||||||
| Address2: | LOVELACE MEDICAL CENTER | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052627000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2006 | ||||||||
| LastUpdateDate: | 04/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A-586-71 | NM | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | A586 | NM | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.