Individual
TYLER JAMES KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6641 DIXIE HWY, LOUISVILLE, KY 40258-3909
(502) 364-0902
(502) 364-0099
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
51057
KY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
51057
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100546170
—
KY
Enumeration date
04/04/2012
Last updated
08/19/2022
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