Individual
MARK L KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2115 N KANSAS AVE, MIDWEST EAR NOSE & THROAT SPECIALISTS PC, HASTINGS, NE 68901-2644
(402) 463-2431
(402) 463-2486
Mailing address
2115 N KANSAS AVE, MIDWEST EAR NOSE & THROAT SPECIALISTS PC, HASTINGS, NE 68901-2644
(402) 463-2431
(402) 463-2486
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
21286
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100448410A
—
KS
01
—
35441
BCBS
NE
05
—
47053662300
—
NE
Enumeration date
12/28/2005
Last updated
07/16/2012
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