Basic Information
| Provider Information | |||||||||
| NPI: | 1841318029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEOGH | ||||||||
| FirstName: | KEVIN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 COOL SPRINGS BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370672626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157784066 | ||||||||
| FaxNumber: | 6157789114 | ||||||||
| Practice Location | |||||||||
| Address1: | 34095 PLYMOUTH RD | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481501511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157784066 | ||||||||
| FaxNumber: | 6157789114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 06/20/2013 | ||||||||
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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 | 2083X0100X | 510108610 | MI | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.