# KENNETH KELLER MD PC

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

## Provider details

- **NPI number:** 1699940304
- **Authorized official:** KENNETH KELLER M.D. (OWNER)
- **Authorized official phone:** (970) 542-1707

## Contact information

- **Practice address:** 220 E BEAVER AVE, FORT MORGAN, CO 80701-3103
- **Practice address phone:** (970) 542-1707
- **Practice address fax:** (970) 542-1708
- **Mailing address:** 220 E BEAVER AVE, FORT MORGAN, CO 80701-3103
- **Mailing address phone:** (970) 542-1707
- **Mailing address fax:** (970) 542-1708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 36926 | CO | Yes |

## Other

- **Enumeration date:** 04/23/2008
- **Last updated:** 07/30/2012