Individual
DR. MICHAEL JOSEPH KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
2301 INDUSTRIAL RD, STE 2020, EMPORIA, KS 66801-6656
(620) 343-8876
(620) 343-8119
Mailing address
2301 INDUSTRIAL RD, STE 2020, EMPORIA, KS 66801-6656
(620) 343-8876
(620) 343-8119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KS-1553
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100348250G
—
KS
01
—
410047515
RAILROAD MEDICARE
KS
01
—
650845
BCBS
—
Enumeration date
11/09/2005
Last updated
04/02/2020
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