Provider Demographics
NPI:1609988989
Name:KEELEY, PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:KEELEY
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 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:1279 OLD ABBOTT MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1889
Practice Address - Country:US
Practice Address - Phone:606-886-1260
Practice Address - Fax:606-886-3590
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007738208100000X
KYTP109208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2303895Medicaid
OHKE4066049Medicare PIN
OHKE4201681Medicare PIN
OH2303895Medicaid
OHKE4066048Medicare PIN
OHKE4066047Medicare PIN
OHKE4201682Medicare PIN
OHKE4066046Medicare PIN
OHKE4201687Medicare PIN