Provider Demographics
NPI:1740235852
Name:KEEVER, ANTHONY TUCKER (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:TUCKER
Last Name:KEEVER
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 1:4 BENCHMARK DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-5125
Mailing Address - Country:US
Mailing Address - Phone:303-817-2840
Mailing Address - Fax:303-544-9101
Practice Address - Street 1:300 EXEMPLA CIR STE 130
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3484
Practice Address - Country:US
Practice Address - Phone:303-539-2296
Practice Address - Fax:303-544-9101
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43622207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10134379Medicaid
COC803007Medicare PIN
COCOB4060Medicare PIN
COC802749Medicare PIN
CO400059Medicare PIN