Individual
DIANNE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2502 N DODGE BLVD, SUITE 190, TUCSON, AZ 85716-2671
(520) 490-4266
(520) 617-1608
Mailing address
2502 N DODGE BLVD, SUITE 190, TUCSON, AZ 85716-2671
(520) 490-4266
(520) 617-1608
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
20611
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113324
—
AZ
Enumeration date
10/16/2006
Last updated
02/18/2011
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