Individual
JESSE DAVID KEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3165 E GREENHURST RD, NAMPA, ID 83686-8655
(208) 463-7330
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-16035
ID
207R00000X
Internal Medicine Physician
MRM-1706
ID
Other
Enumeration date
04/03/2018
Last updated
06/20/2022
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