Provider Demographics
NPI:1427221704
Name:KEANE, JAMES COOPER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:COOPER
Last Name:KEANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22918
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72221-2918
Mailing Address - Country:US
Mailing Address - Phone:501-404-9646
Mailing Address - Fax:
Practice Address - Street 1:11412 HURON LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1847
Practice Address - Country:US
Practice Address - Phone:501-404-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2016-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205964207NS0135X
ARE-6521207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology