NPI 1912026790

Brent Wayne Keenportz, MD

Practitioner Anatomic Pathology & Clinical Pathology Physician Grand Island, NE

Practice location

Address: 2620 W Faidley Ave, Grand Island, NE 68803-4205
Phone: (308) 398-5424
Mailing address: 16405 Weir St, Omaha, NE 68135-1218

Registered specialties

Anatomic Pathology & Clinical Pathology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ZP0102X Licence 19924 (NE)

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Registry record

NPI: 1912026790
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.