Provider Demographics
NPI:1790727824
Name:KEEFE, JOHN HORACE III (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HORACE
Last Name:KEEFE
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 S 79TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-6003
Mailing Address - Country:US
Mailing Address - Phone:918-663-1111
Mailing Address - Fax:918-663-2129
Practice Address - Street 1:5016 S 79TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-6003
Practice Address - Country:US
Practice Address - Phone:918-663-1111
Practice Address - Fax:918-663-2129
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1769111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT75160Medicare ID - Type Unspecified