Individual
KEITH RICHARD KLEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 292-7070
Mailing address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 292-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42521
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021627500
—
MN
01
—
080154948
MEDICARE RAILROAD
MN
Enumeration date
12/07/2005
Last updated
01/30/2024
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