Provider Demographics
NPI:1467539080
Name:FELIX, KEITH FRANCIS (DC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:FRANCIS
Last Name:FELIX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 HERRICK DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-2009
Mailing Address - Country:US
Mailing Address - Phone:973-442-0547
Mailing Address - Fax:
Practice Address - Street 1:129 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6813
Practice Address - Country:US
Practice Address - Phone:973-267-2700
Practice Address - Fax:973-442-0162
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03887111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5004705Medicaid
NJ5004705Medicaid