SearchIdaho207N00000X

Wade Keller, D.O

NPI 1942402169 · on the registry since 2007

Practice

Address
1605 E Riverside Dr
Eagle, ID 83616
Phone
(208) 939-6227
Fax
(208) 939-6442
Organisation at this address
Keller Skin & Cancer Care Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
207N00000X
207N00000X
Also registered as
207N00000X
207ND0101X
207NS0135X
Licence states on file
AZ, ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-11-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho