Individual
VERN ANTOINE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 HOSPITAL DR STE 201, LAFAYETTE, LA 70503-2852
(337) 289-7999
(337) 289-7998
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
021788
LA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
22054
MS
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME114423
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00084714
—
MS
05
—
1977292
—
LA
01
—
330005703
RR MEDICARE
LA
01
—
P01303537
RAILROAD MEDICARE
MS
Enumeration date
07/07/2005
Last updated
12/28/2021
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