Healthcare Provider Details

I. General information

NPI: 1902068281
Provider Name (Legal Business Name): DEBORAH KELLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/04/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 N PIMA RD STE 288
SCOTTSDALE AZ
85258-4488
US

IV. Provider business mailing address

8415 N PIMA RD STE 288
SCOTTSDALE AZ
85258-4488
US

V. Phone/Fax

Practice location:
  • Phone: 480-947-3533
  • Fax: 480-947-3531
Mailing address:
  • Phone: 480-947-3533
  • Fax: 480-947-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT190874
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number77328
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberQ5002
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number288458
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberQ5002
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number77328
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: