MEDICARE: STEVEN J KELLER, D.C, P.A.

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
1	111N00000X	Chiropractor	1525	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350054692	OTHER	AR	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528122231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN J KELLER, D.C, P.A.

Provider Business Mailing Address
First Line	:	1920 WASHINGTON ST
Second Line	:	SUITE B
City	:	CAMDEN
State	:	AR
Zip	:	71701-3134
Country	:	US
Telephone Number	:	870-836-9999
Fax Number	:	870-836-9998

Provider Business Practice Location Address
First Line	:	1920 W WASHINGTON ST
Second Line	:	SUITE B
City	:	CAMDEN
State	:	AR
Zip	:	71701-3134
Country	:	US
Telephone Number	:	870-836-9999
Fax Number	:	870-836-9998

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	STEVEN J. KELLER
Credential	:
Telephone Number	:	870-836-9999

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/26/2016

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