Provider Demographics
NPI:1447252028
Name:KEYES, JOSHUA W (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:W
Last Name:KEYES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3731 GUION ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-7604
Mailing Address - Country:US
Mailing Address - Phone:317-931-0664
Mailing Address - Fax:317-927-0924
Practice Address - Street 1:1791 W LINCOLN ROAD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46092-3274
Practice Address - Country:US
Practice Address - Phone:765-453-7600
Practice Address - Fax:765-453-3861
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001003A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200526490Medicaid
IN4685310001Medicare NSC
IN6071510001Medicare NSC
INP00322317Medicare PIN
IN254400BMedicare PIN
IN200526490Medicaid