Provider Demographics
NPI:1215955703
Name:ZELIGER, KEITH L (DO)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:L
Last Name:ZELIGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-6549
Mailing Address - Fax:814-372-2864
Practice Address - Street 1:761 JOHNSONBURG RD STE 310
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-3480
Practice Address - Country:US
Practice Address - Phone:814-834-1686
Practice Address - Fax:814-834-6279
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005944-L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001053250Medicaid
PA001053250Medicaid
476343Medicare PIN