Individual
IVAN C KETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2835 SW MISSION WOODS DR, TOPEKA, KS 66614-5616
(785) 271-1818
(785) 232-0739
Mailing address
PO BOX 1657, TOPEKA, KS 66601-1657
(785) 295-8108
(785) 231-5991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
422467
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100120190B
—
KS
Enumeration date
07/18/2005
Last updated
03/04/2011
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