| Doctor Name: | DR. DAVID JAY KELLER |
| NPI Number: | 1316933914 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0420005877 |
| Business Practice Address: | 44 Birch St Suite 200 Derry, NH - 030382752 |
| Business Phone Number: | 6034219130 |
| Business Fax Number: | 6034212451 |
| Mailing Address: | 3 Albert Cree Dr, RUTLAND |
| State: | VT |
| Postal Code: | 057014601 |
| Phone Number: | 8027752937 |
| Fax Number: | 8027730934 |
| NPI Enumeration Date: | 09/20/2005 |
| NPI Last Update Date: | 06/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 0420005877 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |