Keith David Clancy in Fort Wayne - Surgery
Keith David Clancy - NPI 1164482303
Keith David Clancy is a Surgery in Fort Wayne, Indiana. Keith David Clancy practices all healthcare services and medical treatments related to Surgery. The NPI Number for Keith David Clancy is 1164482303. The last update date is 2020-09-23.
Keith David Clancy's current location address is 6920 Pointe Inverness Way Ste 200, Fort Wayne, Indiana. You can contact this provider via phone number 2604793514 and fax number 2604793520. The mailing address for Keith David Clancy is 6920 Pointe Inverness Way Ste 200, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keith David Clancy |
|---|---|
| Address | 6920 Pointe Inverness Way Ste 200, Fort Wayne, Indiana |
| Phone Number | 2604793514 |
| Fax Number | 2604793520 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1164482303 |
|---|---|
| Provider Enumeration Date | 2006-03-23 |
| Last Updated Date | 2020-09-23 |
Provider Mailing Address Detail
| Address | 6920 Pointe Inverness Way Ste 200 |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468047934 |
| Phone Number | 2604793514 |
| Fax Number | 2604793520 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | MD067578-L |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1757641 | PA | -- | |
| 117558 | PA | UNISON-WMG | |
| 562564 | PA | HIGHMARK BLUE SHIELD | |
| 39983 | PA | JOHNS HOPKINS | |
| 20006031 | PA | AMERIHEALTH MERCY-WMG | |
| 7731206 | PA | AETNA | |
| 1122002 | PA | CAPITAL BLUE CROSS-WMG | |
| 491516 | PA | MAMSI-WMG | |
| 610201 | MD | CAREFIRST MD BCBS | |
| 1506063 | PA | GATEWAY-WMG |
Post Comment/ Review Below
What is the unique provider identifier assigned to Keith David Clancy?
The Keith David Clancy has been issued the NPI (National Provider Identifier) 1164482303 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where Keith David Clancy's facilities are situated?
The facilities of Keith David Clancy are physically located at the following address: 6920 Pointe Inverness Way Ste 200, Fort Wayne, IN, 468047934.
What is Keith David Clancy's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Keith David Clancy is Surgery, and the taxonomy classification code that categorizes this area of expertise is 208600000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1164482303 to Keith David Clancy?
The Centers for Medicare & Medicaid Services originally issued the 1164482303 to Keith David Clancy on 2006-03-23.
As of what date was the information pertaining to Keith David Clancy, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Keith David Clancy, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-09-23.