Keller, Gregory C

Keller, Gregory C is an individual health care provider with primary practice located at 1325 San Marco Blvd Ste 200 Credentialing Department, Jacksonville FL 32207-8566. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Keller, Gregory C can be contacted via phone (904) 346-3465.

Contact Information

Primary practice address
1325 San Marco Blvd Ste 200 Credentialing Department Jacksonville FL 32207-8566
Phone: (904) 346-3465
Fax: (904) 399-1537
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME62258 Florida
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X ME62258 Florida

Profile Details

NPI number 1285638965
LBN Legal business name Keller, Gregory C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Mar 25th, 2021 - about 3 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 1285638965 NPPES
Georgia MEDICAID 00655069A
Georgia MEDICAID 376096100

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