Individual
DR. TYLER KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 584-4306
Mailing address
MSC 11-6025, UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131
(505) 272-5062
(505) 272-6503
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0057875
CO
390200000X
Student in an Organized Health Care Education/Training Program
'RS2014-0398
NM
Other
Enumeration date
04/03/2014
Last updated
07/21/2022
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