Organization
CARY S KELLER MD PC
Active
Other names
Sportsmedicine Fairbanks
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA S DEAN (EXECUTIVE DIRECTOR)
(907) 451-6561
Entity
Organization
Contact information
Practice address
751 OLD RICHARDSON HWY, SUITE 200, FAIRBANKS, AK 99701-7813
(907) 451-6561
(907) 451-4847
Mailing address
751 OLD RICHARDSON HWY, SUITE 200, FAIRBANKS, AK 99701-7813
(907) 451-6561
(907) 451-4847
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
38793
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG202
—
AK
Enumeration date
05/30/2007
Last updated
08/22/2020
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