Provider Demographics
NPI:1922087675
Name:WILKEY, KEITH D (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:D
Last Name:WILKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:500 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1514
Practice Address - Country:US
Practice Address - Phone:716-375-6993
Practice Address - Fax:716-701-1547
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291815207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04951626Medicaid
MOG63852OtherMERCY
IL214143OtherANTHEM
MO291090OtherCOVENTRY
MO344108OtherHEALTHLINK
MO7229230OtherAETNA
MOP00387962OtherMEDICARE RAILROAD
MO214143OtherANTHEM
MO2146682OtherUNITED HEALTHCARE
MO291090OtherCOVENTRY
IL4208030001Medicare NSC
MO4208030001Medicare NSC
MO929853387Medicare PIN
MO7229230OtherAETNA