# MOUNTAIN EAST FAMILY MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598971780
- **Authorized official:** DR. SCOTT T KELLER D.O. (PRESIDENT)
- **Authorized official phone:** (770) 921-6900

## Contact information

- **Practice address:** 4120 FIVE FORKS TRICKUM RD SW, SUITE 105, LILBURN, GA 30047-3130
- **Practice address phone:** (770) 921-6900
- **Practice address fax:** (770) 921-6313
- **Mailing address:** 4120 FIVE FORKS TRICKUM RD SW, SUITE 105, LILBURN, GA 30047-3130
- **Mailing address phone:** (770) 921-6900
- **Mailing address fax:** (770) 921-6313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 08/22/2020