Provider Demographics
NPI:1235231705
Name:KEELER, F BRENT (MD)
Entity Type:Individual
Prefix:
First Name:F
Middle Name:BRENT
Last Name:KEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14991 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 165
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3983
Mailing Address - Country:US
Mailing Address - Phone:303-690-8333
Mailing Address - Fax:303-690-8315
Practice Address - Street 1:14991 E HAMPDEN AVE
Practice Address - Street 2:SUITE 165
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3983
Practice Address - Country:US
Practice Address - Phone:303-690-8333
Practice Address - Fax:303-690-8315
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21740207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01217405Medicaid
CO9420-4Medicare ID - Type Unspecified
CO01217405Medicaid