Provider Demographics
NPI:1306104419
Name:KELLER, BRETT (DO)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:KELLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-8046
Mailing Address - Fax:484-526-6500
Practice Address - Street 1:755 MEMORIAL PKWY
Practice Address - Street 2:BLDG 200, SUITE 201
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2748
Practice Address - Country:US
Practice Address - Phone:908-859-8884
Practice Address - Fax:908-859-8841
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2016-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09806800207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine