Provider Demographics
NPI:1376988014
Name:MCKEOWN, DAVID GERARD (MBBCH MCH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GERARD
Last Name:MCKEOWN
Suffix:
Gender:M
Credentials:MBBCH MCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-4200
Mailing Address - Fax:814-375-4232
Practice Address - Street 1:761 JOHNSONBURG RD STE 130
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-3480
Practice Address - Country:US
Practice Address - Phone:814-781-1188
Practice Address - Fax:814-781-6828
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD459994208600000X
MAL-255405208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery