Provider Demographics
NPI:1205054210
Name:CONANT, KEITH DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:DAVID
Last Name:CONANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1130 SW MORRISON ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2234
Mailing Address - Country:US
Mailing Address - Phone:503-242-4266
Mailing Address - Fax:503-242-4235
Practice Address - Street 1:1130 SW MORRISON ST
Practice Address - Street 2:SUITE 250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2234
Practice Address - Country:US
Practice Address - Phone:503-242-4266
Practice Address - Fax:503-242-4235
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD217802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry