Provider Demographics
NPI:1417256215
Name:JOHN H KEEFE III DC PC
Entity Type:Organization
Organization Name:JOHN H KEEFE III DC PC
Other - Org Name:KEEFE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HORACE
Authorized Official - Last Name:KEEFE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:918-663-1111
Mailing Address - Street 1:5016 S 79TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-6003
Mailing Address - Country:US
Mailing Address - Phone:918-663-1111
Mailing Address - Fax:918-663-2129
Practice Address - Street 1:5016 S 79TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-6003
Practice Address - Country:US
Practice Address - Phone:918-663-1111
Practice Address - Fax:918-663-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty