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Individual

DR. CARY S KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
751 OLD RICHARDSON HWY, STE# 200, FAIRBANKS, AK 99701-7813
(907) 451-6561
(907) 451-4847
Mailing address
1919 LATHROP ST, STE 105, FAIRBANKS, AK 99701-5937
(907) 451-6561
(907) 451-4847

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
AA3013
AK
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
AA 3013
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD9953
AK
Enumeration date
08/31/2006
Last updated
11/21/2017
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