Individual
JEFFERY W KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD STE 230, GREEN BAY, WI 54311-6519
(920) 288-8250
(920) 288-8255
Mailing address
2845 GREENBRIER RD STE 230, PO BOX 8900, GREEN BAY, WI 54308-8900
(920) 288-8250
(920) 288-8255
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37375
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010061732
RAILROAD
WI
05
—
104289839
—
MI
05
—
104365046
—
MI
05
—
32004300
—
WI
Enumeration date
06/30/2006
Last updated
08/29/2008
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