Keller, Scott T
Keller, Scott T is an individual health care provider with primary practice located at 4120 Five Forks Trickum Rd Sw Suite 105, Lilburn GA 30047-3130. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Keller, Scott T can be contacted via phone (770) 921-6900.Contact Information
Primary practice address
4120 Five Forks Trickum Rd Sw Suite 105
Lilburn GA 30047-3130
Phone: (770) 921-6900
Fax: (770) 921-6313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 024445 | Georgia |
Profile Details
| NPI number | 1609861830 |
|---|---|
| LBN Legal business name | Keller, Scott T |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2005 |
| Last updated | Oct 30th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609861830 | NPPES |
| Georgia | MEDICAID | 00275272D |
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