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NPI Code Detail

MEDICARE: WYATT LEE KECK MD

MEDICARE: WYATT LEE KECK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207L00000XAnesthesiology PhysicianMD494416PA

General Provider Information

NPI Number : 1417697616
Entity Type Code : Individual
Provider Name (Legal Business Name) : WYATT LEE KECK MD
Provider Business Mailing Address
First Line : 601 MEMORY LN
Second Line :
City : YORK
State : PA
Zip : 17402-2231
Country : US
Telephone Number : 717-851-1405
Fax Number : 717-851-6969
Provider Business Practice Location Address
First Line : 112 N 7TH ST
Second Line :
City : CHAMBERSBURG
State : PA
Zip : 17201-1720
Country : US
Telephone Number : 717-267-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2022
Last Update Date : 06/03/2026

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Directions to “ WYATT LEE KECK MD” Practice Location

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