Individual
LISA KAY KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
940 ROYAL AVENUE, SUITE 350, MEDFORD, OR 97504-6194
(541) 732-7460
(541) 732-7461
Mailing address
919 REDDY AVENUE, MEDFORD, OR 97504-7438
(541) 245-9116
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
G38545
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD27247
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G385451
—
CA
Enumeration date
07/12/2006
Last updated
08/22/2022
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