Henry, Keith Allen
Henry, Keith Allen is an individual health care provider with primary practice located at 7950 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Henry, Keith Allen can be contacted via phone (260) 435-2772.Contact Information
Primary practice address
7950 W Jefferson Blvd
Fort Wayne IN 46804-4140
Phone: (260) 435-2772
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 51606 | Texas |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 54071 | Kentucky |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD2020-0138 | New Mexico |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 30299 | Wisconsin |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 01092894A | Indiana |
Profile Details
| NPI number | 1447261201 |
|---|---|
| LBN Legal business name | Henry, Keith Allen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Apr 2nd, 2024 - about 8 months 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 | 1447261201 | NPPES |
| Wisconsin | MEDICAID | 32093700 | |
| Wisconsin | MEDICAID | 7100668960 |
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