Provider Demographics
NPI:1578593984
Name:KEOGH, JOSEPH HUGH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HUGH
Last Name:KEOGH
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 1:1430 PARKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3454
Mailing Address - Country:US
Mailing Address - Phone:617-872-5747
Mailing Address - Fax:781-862-3005
Practice Address - Street 1:1430 PARKINSON AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3454
Practice Address - Country:US
Practice Address - Phone:617-872-5747
Practice Address - Fax:781-862-3005
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75281208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics