Bob Keophakdy, IDMT
Military Health Care Provider, Independent Duty Medical Technicians in Charleston, South Carolina
1124797410- Practice location
- 204 W Hill Blvd, Charleston, SC 29404-4704
- Phone
- 843-963-6880
- Fax
- —
- Last updated
- December 3, 2025
Bob Keophakdy is a Military Health Care Provider, Independent Duty Medical Technicians based in Charleston, SC. Bob Keophakdy practices in Charleston, SC and has the professional credentials of IDMT. The NPI Number for Bob Keophakdy is 1124797410. The current practice location address for Bob Keophakdy is 204 W Hill Blvd, Charleston, SC 29404-4704 and can be reached out via phone at 843-963-6880.
Provider Profile Details
- NPI Number
- 1124797410
- Provider Name
- Bob Keophakdy
- Credential
- IDMT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 204 W Hill Blvd, Charleston, SC 29404-4704
- Phone Number
- 843-963-6880
- Primary Taxonomy
- Military Health Care Provider, Independent Duty Medical Technicians · 1710I1003X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 9, 2021
- Last Update Date
- December 3, 2025
- Certification Date
- December 3, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 204 W Hill Blvd
Charleston, SC 29404-4704 - City
- Charleston
- State
- South Carolina
- Zip
- 29404-4704
- Phone Number
- 843-963-6880
Provider Business Mailing Address Details
- Address
- Psc 62 Box 7002
Apo, AE 09643-0071 - City
- Apo
- State
- AE
- Zip
- 09643-0071
- Phone Number
- 314-722-8069
License Information
- Taxonomy
- Military Health Care Provider, Independent Duty Medical Technicians · 1710I1003X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Bob Keophakdy, IDMT?
The NPI number of Bob Keophakdy, IDMT is 1124797410. It was assigned on September 9, 2021 and is currently active in the NPPES registry.
What is the specialty of Bob Keophakdy, IDMT?
Bob Keophakdy, IDMT is registered under the primary taxonomy Military Health Care Provider, Independent Duty Medical Technicians (code 1710I1003X).
Where does Bob Keophakdy, IDMT practice?
The practice location is 204 W Hill Blvd, Charleston, SC 29404-4704. The office can be reached at 843-963-6880 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1124797410 directly on the NPPES registry website.