# CARY S KELLER MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sportsmedicine Fairbanks
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922127992
- **Authorized official:** REBECCA S DEAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (907) 451-6561

## Contact information

- **Practice address:** 1919 LATHROP ST, SUITE 105, FAIRBANKS, AK 99701-5937
- **Practice address phone:** (907) 451-6561
- **Practice address fax:** (907) 451-4847
- **Mailing address:** 1919 LATHROP ST, SUITE 105, FAIRBANKS, AK 99701-5937
- **Mailing address phone:** (907) 451-6561
- **Mailing address fax:** (907) 451-4847

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 38793 | AK | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | 38793 | AK | — |
| 2083S0010X | Sports Medicine (Preventive Medicine) Physician | 38793 | AK | — |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 06/07/2013