Provider Demographics
NPI:1053457408
Name:ATTKISS, KEITH J (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:J
Last Name:ATTKISS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2 1/2 DEARFIELD DRIVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831
Mailing Address - Country:US
Mailing Address - Phone:203-862-2700
Mailing Address - Fax:203-869-5915
Practice Address - Street 1:TWO AND A HALF DEARFIELD DRIVE
Practice Address - Street 2:SUITE 203
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831
Practice Address - Country:US
Practice Address - Phone:203-862-2700
Practice Address - Fax:203-869-5915
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
CT038351208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG34875Medicare UPIN