Doctor Name: | JOHN JAY KEIZUR |
NPI Number: | 1578663399 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD00034193 |
Business Practice Address: | 825 Se Bishop Blvd Suite 101 Pullman, WA - 991635517 |
Business Phone Number: | 5093323488 |
Business Fax Number: | 5093346477 |
Mailing Address: | 825 Se Bishop Blvd, Suite 101 PULLMAN |
State: | WA |
Postal Code: | 991635517 |
Phone Number: | 5093323488 |
Fax Number: | 5093346477 |
NPI Enumeration Date: | 09/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD00034193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |