Provider Demographics
NPI:1457575011
Name:O'KEEFE, SIOBHAN (MB,BCH,BAO)
Entity type:Individual
Prefix:DR
First Name:SIOBHAN
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:MB,BCH,BAO
Other - Prefix:DR
Other - First Name:SIOBHAN
Other - Middle Name:
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MB, BCH, BAO
Mailing Address - Street 1:13001 E. 17TH PLACE
Mailing Address - Street 2:UNIVERSITY OF COLORADO GME
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2581
Mailing Address - Country:US
Mailing Address - Phone:303-724-2393
Mailing Address - Fax:720-777-7324
Practice Address - Street 1:13001 E. 17TH PLACE
Practice Address - Street 2:UNIVERSITY OF COLORADO GME
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2581
Practice Address - Country:US
Practice Address - Phone:303-724-2393
Practice Address - Fax:720-777-7324
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00442207R00000X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5915309Medicaid
NC1589UOtherBCBSNC
NC2076377Medicare PIN