| Doctor Name: | DR. KEITH MILO ERNST |
| NPI Number: | 1003036526 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 02000141A |
| Business Practice Address: | 153 N. Main St. Cloverdale, IN - 461200188 |
| Business Phone Number: | 7657954241 |
| Business Fax Number: | |
| Mailing Address: | Po Box 188, CLOVERDALE |
| State: | IN |
| Postal Code: | 461200188 |
| Phone Number: | 7657954241 |
| Fax Number: | |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02000141A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |