Provider Demographics
NPI:1982728804
Name:KEYSER, JOHN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:KEYSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 ATKINS RD
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:MI
Mailing Address - Zip Code:48049-4506
Mailing Address - Country:US
Mailing Address - Phone:810-085-5675
Mailing Address - Fax:
Practice Address - Street 1:4950 ATKINS RD
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:MI
Practice Address - Zip Code:48049-4506
Practice Address - Country:US
Practice Address - Phone:810-985-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036425207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology