| Dr Jack Keller Pc | |
|
1008 West Cherry Ste F Marion IL 62959 | |
| (618) 997-2919 | |
| (618) 997-6851 |
| Full Name | Dr Jack Keller Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1008 West Cherry, Marion, Illinois |
| Authorized Official Name and Position | Jack D Keller (PRESIDENT) |
| Authorized Official Contact | 6189972919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jack Keller Pc 1008 West Cherry Ste F Marion IL 62959 Ph: (618) 997-2919 | Dr Jack Keller Pc 1008 West Cherry Ste F Marion IL 62959 Ph: (618) 997-2919 |
| NPI Number | 1215011259 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 11/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215011259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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