NPI 1942402169

Wade Robert Keller, DO

Practitioner Dermatology Physician Eagle, ID

Practice location

Address: 1605 E Riverside Dr, Eagle, ID 83616-6237
Phone: (208) 939-6227
Fax: (208) 939-6442
Mailing address: 1605 E Rverside Drive, Eagle, ID 83616

Registered specialties (4)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence O-0559 (ID)

Other Dermatology providers in Idaho →

Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 4692 (AZ)

MOHS-Micrographic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X Licence O-0559 (ID)

Procedural Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X Licence O-0559 (ID)

Registry record

NPI: 1942402169
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Jun 2007
Record last updated: 3 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.