Individual
DR. SCOTT T KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4120 FIVE FORKS TRICKUM RD SW, SUITE 105, LILBURN, GA 30047-3130
(770) 921-6900
(770) 921-6313
Mailing address
4120 FIVE FORKS TRICKUM RD SW, SUITE 105, LILBURN, GA 30047-3130
(770) 921-6900
(770) 921-6313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024445
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00275272D
—
GA
Enumeration date
09/14/2005
Last updated
10/30/2007
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