Keller, Scott Robert

Keller, Scott Robert is an individual health care provider with primary practice located at 3 Park Pl , Swansea IL 62226-2965. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Keller, Scott Robert can be contacted via phone (618) 222-9244.

Contact Information

Primary practice address
3 Park Pl Swansea IL 62226-2965
Phone: (618) 222-9244
Fax: (618) 222-9248
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2007011139 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2004014306 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036.132786 Illinois

Profile Details

NPI number 1003942145
LBN Legal business name Keller, Scott Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2007
Last updated Oct 2nd, 2013 - about 12 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 1003942145 NPPES
Missouri MEDICAID 209903004

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