Provider Demographics
NPI:1598973851
Name:KEEN, PHILIP EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:EARL
Last Name:KEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4060 W GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-2731
Mailing Address - Country:US
Mailing Address - Phone:602-843-5205
Mailing Address - Fax:602-547-9337
Practice Address - Street 1:980 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1604
Practice Address - Country:US
Practice Address - Phone:928-771-3163
Practice Address - Fax:928-771-3105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ7417207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology