Provider Demographics
NPI:1790711885
Name:KEONIN, JASON ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ROBERT
Last Name:KEONIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1823 HIGHWAY BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-2226
Mailing Address - Country:US
Mailing Address - Phone:712-262-6320
Mailing Address - Fax:712-264-3007
Practice Address - Street 1:1823 HIGHWAY BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-2226
Practice Address - Country:US
Practice Address - Phone:712-262-6320
Practice Address - Fax:712-264-3007
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-06-28
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Provider Licenses
StateLicense IDTaxonomies
IA38989208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery