Patrick Keenan, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Rutland, VT
NPI 1679545669 · NPPES record last updated Jul 18, 2013
Key facts
- NPI
- 1679545669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 042-0005344 (VT)
- Practice address
- 147 Allen St
Rutland, VT 05701-4555 - Phone
- (802) 775-1901
- Fax
- (802) 775-1974
- NPI assigned
- Feb 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0005344 | VT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid Vermont OB-GYN | Obstetrics & Gynecology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 042-0005344 | VT | Yes |
Addresses
Primary practice location
147 Allen St
Rutland, VT 05701-4555
Mailing address
147 Allen St
Rutland, VT 05701-4555
Phone (802) 775-1901
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009658 | Medicaid | VT |
Other providers in Rutland, VT
- Andrew Vincent Juettner III
- Julia Frankel Pmhnp PLLC
- Carolyn Elizabeth Kane
- John W Karl
- Kammie Kendra Kayl
- Keene Medical Products, LLC
- Jason William Keicher
- William Daniel Kelley Jr.
- Laurel H Kelliher
- Carlton L. Kellogg
All providers in Rutland, VT · Obstetrics & Gynecology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.