Michael P Keller MD PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

2001-231 Issued in NM

Legal business name

MICHAEL P KELLER MD PC

Practice address

3900 E Lohman Ave Ste B
Las Cruces, NM 88011-8274

Phone

(505) 522-5955

Fax

(505) 522-6228

NPI assigned

Jun 8, 2007

Last updated

Sep 24, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tony Kinkade

Title

Business Manager

Phone

(505) 522-5955

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1932302650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E LOHMAN AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118274",
            "telephone_number": "505-522-5955",
            "fax_number": "505-522-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E LOHMAN AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118274",
            "telephone_number": "505-522-5955",
            "fax_number": "505-522-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL P KELLER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "KINKADE",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "505-522-5955"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NM",
            "license": "2001-231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Vascular Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.