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Dr. Keith E Proctor, DO
Student in an Organized Health Care Education/Training Program in Ronceverte, West Virginia
NPI 1407021694

Keith E Proctor is a Student in an Organized Health Care Education/Training Program based in Ronceverte, WV. Keith E Proctor practices in Ronceverte, WV and has the professional credentials of DO. The NPI Number for Keith E Proctor is 1407021694 and holds a License No. TRAINING LICENSE (West Virginia).

The current practice location address for Keith E Proctor is 202 Maplewood Ave, Ronceverte, WV and can be reached out via phone at 304-647-6529 and via fax at 304-793-2279.

Location: 202 Maplewood Ave, Ronceverte, WV, 24970-1334
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407021694
Provider Name
Keith E Proctor
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
202 Maplewood Ave, Ronceverte, WV, 24970-1334
Phone Number
304-647-6529
Fax Number
304-793-2279
Provider Enumeration Date
04/28/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
202 Maplewood Ave
City
Ronceverte
State
West Virginia
Zip
24970-1334
Phone Number
304-647-6529
Fax Number
304-793-2279
person
Provider Business Mailing Address Details
Address
202 Maplewood Ave
City
Ronceverte
State
West Virginia
Zip
24970-1334
Phone Number
304-647-6529
Fax Number
304-793-2279
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
TRAINING LICENSE (West Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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