Doctor Name: | JAY S KELLER |
NPI Number: | 1790760544 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 16383 |
Business Practice Address: | 1 Memorial Drive Suite 300 Decatur, IL - 625266322 |
Business Phone Number: | 2178722400 |
Business Fax Number: | 2178754680 |
Mailing Address: | 1 Memorial Drive, Suite 300 DECATUR |
State: | IL |
Postal Code: | 625266322 |
Phone Number: | 2178722400 |
Fax Number: | 2178754680 |
NPI Enumeration Date: | 12/14/2005 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 16383 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |