Provider Demographics
NPI:1821074675
Name:O'KEEFE, KATHLEEN ALICE (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ALICE
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 ANDOVER ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5044
Mailing Address - Country:US
Mailing Address - Phone:978-686-7623
Mailing Address - Fax:978-683-9911
Practice Address - Street 1:451 ANDOVER ST
Practice Address - Street 2:SUITE 209
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5044
Practice Address - Country:US
Practice Address - Phone:978-686-7623
Practice Address - Fax:978-683-9911
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0304213E00000X
MA2207213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH03Y007457NH02OtherANTHEM BLUECROSS BLUE SHIELD
NHDC3586OtherPALMETTO GBA RAILROAD MEDICARE
NH03Y007457NH02OtherANTHEM BLUECROSS BLUE SHIELD
NHDC3586OtherPALMETTO GBA RAILROAD MEDICARE
MARE7722Medicare PIN
NHDC3586OtherPALMETTO GBA RAILROAD MEDICARE