Provider Demographics
NPI:1598795148
Name:KEEFOVER, ROBERT WARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WARD
Last Name:KEEFOVER
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 1:145 ROCK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-6121
Mailing Address - Country:US
Mailing Address - Phone:304-363-1156
Mailing Address - Fax:888-261-5928
Practice Address - Street 1:1 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-1283
Practice Address - Country:US
Practice Address - Phone:304-265-7092
Practice Address - Fax:304-265-5431
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV143692084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVA72505Medicare UPIN
WVKE6020391Medicare ID - Type Unspecified