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Individual

DR. KEITH EMERY KELLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
446 CORPORATE DRIVE, HOUMA, LA 70360-3403
(985) 872-5577
(985) 868-4190
Mailing address
446 CORPORATE DRIVE, HOUMA, LA 70360-3403
(985) 872-5577
(985) 868-4190

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
022479
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679640
LA
Enumeration date
07/14/2005
Last updated
07/08/2007
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