Keithahn, Mari Ann
Keithahn, Mari Ann is an individual health care provider with primary practice located at 105 N Keene St Ste 102 , Columbia MO 65201-8131. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Retina Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Keithahn, Mari Ann can be contacted via phone (573) 777-8738.Contact Information
Primary practice address
105 N Keene St Ste 102
Columbia MO 65201-8131
Phone: (573) 777-8738
Fax: (573) 777-8739
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 111416 | Missouri |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 111416 | Missouri |
Profile Details
| NPI number | 1902880313 |
|---|---|
| LBN Legal business name | Keithahn, Mari Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Jun 29th, 2021 - about 4 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 | 1902880313 | NPPES |
| Missouri | Other | 101298 | BLUE CROSS BLUE SHIELD |
| Missouri | MEDICAID | 208468504 | BLUE CROSS BLUE SHIELD |
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