Basic Information
| Provider Information | |||||||||
| NPI: | 1497919567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEITH | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DIVISION OF PLASTIC & RECONSTRUCTIVE SURGERY | ||||||||
| Address2: | 3550 TERRACE ST, SCAIFE HALL, SUTIE 6B | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152610001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123838082 | ||||||||
| FaxNumber: | 4126481987 | ||||||||
| Practice Location | |||||||||
| Address1: | DIVISION OF PLASTIC & RECONSTRUCTIVE SURGERY | ||||||||
| Address2: | 3550 TERRACE ST, SCAIFE HALL, SUTIE 6B | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152610001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123838082 | ||||||||
| FaxNumber: | 4126481987 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2008 | ||||||||
| LastUpdateDate: | 07/17/2008 | ||||||||
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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 | 208200000X | MT189076 | PA | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.