Individual
DWAYNE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 E STONER AVE, OVERTON-BROOKS VA MEDICAL CENTER, SHREVEPORT, LA 71101-4243
(318) 424-6025
(318) 841-4796
Mailing address
510 E. STONER AVE., OVERTON BROOKS VA MEDICAL CENTER, SHREVEPORT, LA 71101
(318) 990-5325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.020144
LA
Other
Enumeration date
08/11/2006
Last updated
12/09/2015
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