Individual
PAUL LEROY KELLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12368 STRATFORD DR, SUITE 300, CLIVE, IA 50325-8162
(515) 226-9810
(515) 226-8408
Mailing address
528 S 34TH CT, WEST DES MOINES, IA 50265-7993
(515) 208-1115
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
26231
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3189860
—
IA
Enumeration date
05/01/2006
Last updated
07/08/2007
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