Provider Demographics
NPI:1275510919
Name:METZLER, KEITH ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALAN
Last Name:METZLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2321 WARDS RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2101
Mailing Address - Country:US
Mailing Address - Phone:434-582-2273
Mailing Address - Fax:434-582-1363
Practice Address - Street 1:2321 WARDS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2101
Practice Address - Country:US
Practice Address - Phone:434-582-2273
Practice Address - Fax:434-582-1363
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010319510Medicaid
P00308691OtherMEDICARE RAILROAD PROVIDER NUMBER
298370OtherANTHEM
VA010319510Medicaid
298370OtherANTHEM