Provider Demographics
NPI:1851487805
Name:KEYSER & O'CONNOR SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:KEYSER & O'CONNOR SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-733-4644
Mailing Address - Street 1:804 GRANDVIEW DR
Mailing Address - Street 2:STE 3
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1635
Mailing Address - Country:US
Mailing Address - Phone:717-733-4644
Mailing Address - Fax:
Practice Address - Street 1:804 GRANDVIEW DR
Practice Address - Street 2:STE 3
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1635
Practice Address - Country:US
Practice Address - Phone:717-733-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067541Medicare ID - Type UnspecifiedGROUP PROV NUMBER