Keith J Moody D O P C

LBN: Keith J Moody D O P C
Keith J Moody D O P C is an health care organization with primary practice located at 200 S Wenona St Suite 225, Bay City MI 48706-8820. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is the primary health care specialty. Keith J Moody D O P C can be contacted via phone (989) 893-9705, or through Moody D O, Keith J via phone (989) 893-9705.

Contact Information

Primary practice address
200 S Wenona St Suite 225 Bay City MI 48706-8820
Phone: (989) 893-9705
Fax: (989) 893-8206
Website:
Map and Directions
Authorized official contact:
Name: Moody D O, Keith J Doctor of Osteopathy (DO)
Phone: (989) 893-9705

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 5101008328 Michigan
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 5101008328 Michigan

Profile Details

NPI number 1295917524
LBN Legal business name Keith J Moody D O P C
DBA Doing business as
Authorized official Moody D O, Keith J Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2007
Last updated Nov 28th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295917524 NPPES
Michigan MEDICAID 4164290
Michigan Other 1150900464
Michigan Other 1006214
Michigan Other 1150900464
Michigan Other 50900464
Michigan Other 28233
Michigan Other 16613
Michigan Other 4220040
Michigan Other 1150900464

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