Keller, Candace

Keller, Candace is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Keller, Candace can be contacted via phone (601) 984-5900.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5900
Fax: (601) 984-5939
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 08368 Mississippi

Profile Details

NPI number 1346207362
LBN Legal business name Keller, Candace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jan 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346207362 NPPES
Mississippi MEDICAID 050000792
Mississippi Other P00462245
Mississippi Other 201397813A
Mississippi Other P01236761

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