Individual
JEFFREY KETCHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12753 MISSION MEADOW DR, COLORADO SPRINGS, CO 80921-7659
(831) 333-6159
Mailing address
12753 MISSION MEADOW DR, COLORADO SPRINGS, CO 80921-7659
(831) 333-6159
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD15412
SC
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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