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Individual

WILLIAM F KETTERER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
332 DEWEY ST, BENNINGTON, VT 05201-2225
(802) 442-6314
(802) 447-1686
Mailing address
332 DEWEY ST, BENNINGTON, VT 05201-2225
(802) 442-6314
(802) 447-1686

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0420006531
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005117
VT
01
18154
MVP
VT
01
200010961
RAILROAD MEDICARE/ PALMETTO
VT
01
ORTHO5117
BCBS
VT
Enumeration date
08/26/2005
Last updated
10/08/2008
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