Individual
KURT WILLIAM KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4864 JACKSON ST, MONROE, LA 71202-6400
(318) 330-7000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
319985
LA
207P00000X
Emergency Medicine Physician
S9006
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
10/14/2022
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