Organization
JACK E. KEISER,JR.,M.D.,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK E KEISER JR. M.D. (CEO/UROLOGIST)
(315) 253-2785
Entity
Organization
Contact information
Practice address
50 BROOKHOLLOW DR, AUBURN, NY 13021-9654
(315) 252-0200
Mailing address
50 BROOKHOLLOW DR, AUBURN, NY 13021-9654
(315) 252-0200
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
137461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00468575
—
NY
Enumeration date
10/02/2007
Last updated
08/07/2013
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