Provider Demographics
NPI:1639143605
Name:KEELING, TIMOTHY B (DO)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:B
Last Name:KEELING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1241 W MINERAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5685
Mailing Address - Country:US
Mailing Address - Phone:303-759-0854
Mailing Address - Fax:303-759-0864
Practice Address - Street 1:HIGHWAY 9 AT PEAK ONE ROAD
Practice Address - Street 2:ST ANTHONY SUMMIT MEDICAL CENTER, EMERGENCY DEPT
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-3300
Practice Address - Fax:970-668-8123
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO29387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200384240AMedicaid
WY122688600Medicaid
UTZ3270Medicaid
CO01293877Medicaid
AZ129198Medicaid
NM73588571Medicaid
AZ129198Medicaid
COC803426Medicare PIN