Keith William Cespon, OD
Individual provider Active NPI Optometrist · Santa Fe, NM
NPI 1851487474 · NPPES record last updated Nov 7, 2007
Key facts
- NPI
- 1851487474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 954 (AZ)
- Practice address
- 1700 Cerrillos Rd
Santa Fe, NM 87505 - Phone
- (505) 946-9218
- Fax
- (505) 983-6243
- NPI assigned
- Oct 4, 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 954 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santo Domingo Health Clinic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 954 | AZ | Yes |
Addresses
Primary practice location
1700 Cerrillos Rd
Santa Fe, NM 87505
Mailing address
1700 Cerrillos Rd
Santa Fe, NM 87505-3554
Phone (505) 946-9218
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7835361 | Medicaid | NM |
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2007. 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.