Provider Demographics
NPI:1093732653
Name:KEIPER, GLENN L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:L
Last Name:KEIPER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1410 OAK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4604
Mailing Address - Country:US
Mailing Address - Phone:541-485-2357
Mailing Address - Fax:541-485-2358
Practice Address - Street 1:1410 OAK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4604
Practice Address - Country:US
Practice Address - Phone:541-485-2357
Practice Address - Fax:541-485-2358
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-01-10
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Provider Licenses
StateLicense IDTaxonomies
ORMD20444207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR130609Medicare ID - Type Unspecified