Individual
DR. GEORGE D KECKEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 MEETING HOUSE LN, BLDG #2, SOUTHAMPTON, NY 11968-5087
(631) 283-2100
(631) 283-5731
Mailing address
PO BOX 2340, SOUTHAMPTON, NY 11969-2340
(631) 283-2430
(631) 283-7496
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
151417
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01521420
—
NY
01
—
27263
VYTRA
NY
Enumeration date
09/14/2006
Last updated
01/11/2011
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