Provider Demographics
NPI:1447246772
Name:SAXON, KEITH GORDON (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:GORDON
Last Name:SAXON
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 1:5308 HUNTINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1368
Mailing Address - Country:US
Mailing Address - Phone:301-213-6482
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DRIVE
Practice Address - Street 2:BUILDING 10, ROOM 5D/38
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-402-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8C73207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology