Provider Demographics
NPI:1073576377
Name:O'KEEFE, JOHN STEWART (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEWART
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 STONY POINT PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1989
Mailing Address - Country:US
Mailing Address - Phone:804-644-7478
Mailing Address - Fax:804-644-8224
Practice Address - Street 1:8720 STONY POINT PKWY STE 105
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1989
Practice Address - Country:US
Practice Address - Phone:804-644-7478
Practice Address - Fax:804-644-8224
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235908207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010170141Medicaid
H57376Medicare UPIN
VA010170141Medicaid