Provider Demographics
NPI:1396474227
Name:RODGERS, KEITH ALLAN (AUD, CCC-A, ABAC)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALLAN
Last Name:RODGERS
Suffix:
Gender:M
Credentials:AUD, CCC-A, ABAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 NAAB RD STE 235
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1932
Mailing Address - Country:US
Mailing Address - Phone:317-926-9117
Mailing Address - Fax:317-923-5729
Practice Address - Street 1:8330 NAAB RD STE 235
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1932
Practice Address - Country:US
Practice Address - Phone:317-926-9117
Practice Address - Fax:317-923-5729
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002793A237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter