Provider Demographics
NPI:1346270048
Name:KEYLOR, REBECCA S (CRNA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:KEYLOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT L 2312
Mailing Address - Street 2:DOCTORS ANESTHESIA SERVICES
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-2312
Mailing Address - Country:US
Mailing Address - Phone:800-270-2955
Mailing Address - Fax:440-247-4331
Practice Address - Street 1:6520 WEST CAMPUS OVAL
Practice Address - Street 2:CENTRAL OHIO SURGICAL INSTITUTE
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054
Practice Address - Country:US
Practice Address - Phone:614-413-2233
Practice Address - Fax:614-413-2234
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN153737207L00000X
OHNA03207207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0760458Medicaid
8213116Medicare ID - Type Unspecified