Provider Demographics
NPI:1366409955
Name:KEELER, LOUIS L III (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:L
Last Name:KEELER
Suffix:III
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 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:
Practice Address - Street 1:2090 SPRINGDALE RD STE D
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2024
Practice Address - Country:US
Practice Address - Phone:877-388-2778
Practice Address - Fax:856-751-2454
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05934100208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6095500Medicaid
KE743423Medicare ID - Type Unspecified
NJ6095500Medicaid