Berghoff, Keenan R
Berghoff, Keenan R is an individual health care provider with primary practice located at 2790 Clay Edwards Dr Ste 625 , North Kansas City MO 64116-3278. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Berghoff, Keenan R can be contacted via phone (816) 455-3990.Contact Information
Primary practice address
2790 Clay Edwards Dr Ste 625
North Kansas City MO 64116-3278
Phone: (816) 455-3990
Fax: (816) 455-5351
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01063361A | Indiana |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 115623 | Missouri |
Profile Details
NPI number | 1720027212 |
---|---|
LBN Legal business name | Berghoff, Keenan R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 6th, 2006 |
Last updated | Feb 18th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1720027212 | NPPES |
Indiana | Other | 000000607167 | ANTHEM |
Indiana | MEDICAID | 200855420 | ANTHEM |
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