Provider Demographics
NPI:1720264799
Name:STIGER, KEITH E
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:E
Last Name:STIGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-5402
Mailing Address - Country:US
Mailing Address - Phone:570-323-3698
Mailing Address - Fax:570-326-2579
Practice Address - Street 1:1425 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5402
Practice Address - Country:US
Practice Address - Phone:570-323-3698
Practice Address - Fax:570-326-2579
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001998L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA350040046OtherRAILROAD MEDICARE
PA0043657000OtherINDEPENDANCE BC
50010109OtherCAPITAL
PAST124597OtherBLUE SHIELD
PA804519OtherFIRST PRIORITY
50010109OtherCAPITAL