Provider Demographics
NPI:1073831319
Name:KEYES, PAUL CARLOS (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CARLOS
Last Name:KEYES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 MAYSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-8855
Mailing Address - Country:US
Mailing Address - Phone:740-588-0761
Mailing Address - Fax:740-588-0764
Practice Address - Street 1:2770 MAYSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-8855
Practice Address - Country:US
Practice Address - Phone:740-588-0761
Practice Address - Fax:740-588-0764
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03213818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist