Healthcare Provider Details

I. General information

NPI: 1730178914
Provider Name (Legal Business Name): CHARLES FRANCIS KELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 GREENE ST
ADEL IA
50003-1712
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-993-4656
  • Fax: 515-993-4532
Mailing address:
  • Phone: 515-993-4656
  • Fax: 515-993-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42222
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-34238
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: