Individual
PHILIP E KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 WALTER SCHOLER DR, LAFAYETTE, IN 47909-6303
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01066617A
IN
207Q00000X
Family Medicine Physician
23984
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000631756
ANTHEM PROVIDER NUMBER
IN
01
—
080076573
RAILROAD MEDICARE
WI
01
—
12550
DEAN
WI
05
—
200960920
—
IN
01
—
23984
TOUCHPOINT
WI
05
—
30500300
—
WI
01
—
39080723640
UNITY
WI
01
—
WI0140
JOHN DEERE
WI
Enumeration date
11/15/2005
Last updated
08/13/2012
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