Individual
JOHN P KETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642
(585) 273-3126
(585) 273-3126
Mailing address
BOX 665, 601 ELMWOOD AVE, ROCHESTER, NY 14642
(585) 273-3126
(585) 756-4721
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME 97677
FL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
ME 97677
FL
207XX0801X
Orthopaedic Trauma Physician
Primary
258179
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073522652
—
VA
05
—
27844830-0
—
FL
01
—
310407
AVMED
FL
01
—
5918946
CIGNA
FL
01
—
96123
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
08/05/2006
Last updated
07/06/2023
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