Provider Demographics
NPI:1790761047
Name:KEITH, LINDA J (DO)
Entity Type:Individual
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First Name:LINDA
Middle Name:J
Last Name:KEITH
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1700 BOETTLER RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7792
Mailing Address - Country:US
Mailing Address - Phone:330-896-0009
Mailing Address - Fax:330-896-0032
Practice Address - Street 1:1700 BOETTLER RD
Practice Address - Street 2:STE. 100
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7792
Practice Address - Country:US
Practice Address - Phone:330-896-0009
Practice Address - Fax:330-896-0032
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2023-07-28
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Provider Licenses
StateLicense IDTaxonomies
OH34007151207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2275318Medicaid
OH080185622OtherRAILROAD MEDICARE
OHH54525Medicare UPIN
OH4067413Medicare PIN