Keck, Kevin W

Keck, Kevin W is an individual health care provider with primary practice located at 12442 Sw Scholls Ferry Rd Suite 100, Tigard OR 97223-3396. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Keck, Kevin W can be contacted via phone (503) 215-9900.

Contact Information

Primary practice address
12442 Sw Scholls Ferry Rd Suite 100 Tigard OR 97223-3396
Phone: (503) 215-9900
Fax: (503) 215-9266
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD21667 Oregon
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD21667 Oregon

Profile Details

NPI number 1427092428
LBN Legal business name Keck, Kevin W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427092428 NPPES
Oregon MEDICAID 136343

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