DR. CHARLES ROBERT KELLER D.O. NPI 1629189311

NPI Information

NPI: 1629189311
Provider Name: DR. CHARLES ROBERT KELLER, D.O.
Classification: Family Medicine - 207QA0505X
Entity Type: Individual

Specialization: Adult Medicine

PECOS Registration: Yes

Address:
1383 W HUNTER ST
LOGAN, OH
ZIP 43138
Phone: (740) 385-0202
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DR. Charles Robert Keller, D.O. is an adult medicine family medicine in Logan, OH. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. DR. Charles Robert Keller, D.O. NPI is 1629189311. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1383 W HUNTER ST
LOGAN, OH
ZIP 43138-013
Phone: (740) 385-0202
Fax: (740) 380-2734

The NPI 1629189311 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 11/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	34003787	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0565240	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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