Provider Demographics
NPI:1770879546
Name:KEESLING, RACHEL J (DO)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:J
Last Name:KEESLING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4190 E WOODMEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-8075
Mailing Address - Country:US
Mailing Address - Phone:719-387-0502
Mailing Address - Fax:
Practice Address - Street 1:720 W US HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-8968
Practice Address - Country:US
Practice Address - Phone:719-686-0878
Practice Address - Fax:719-686-7331
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CO0054029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84720727Medicaid