Provider Demographics
NPI:1205047396
Name:KEEGAN, ARTHUR WARD (DC)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:WARD
Last Name:KEEGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MADISON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2058
Mailing Address - Country:US
Mailing Address - Phone:508-798-2002
Mailing Address - Fax:508-798-0618
Practice Address - Street 1:90 MADISON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2058
Practice Address - Country:US
Practice Address - Phone:508-798-2002
Practice Address - Fax:508-798-0618
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1612506Medicaid
MAU57314Medicare UPIN