Provider Demographics
NPI:1902334352
Name:ZOELLER, KEITH ARMAND (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:ARMAND
Last Name:ZOELLER
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 1:1215 HESS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1744
Mailing Address - Country:US
Mailing Address - Phone:502-852-0864
Mailing Address - Fax:
Practice Address - Street 1:200 CARDINAL DR STE 312
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2787
Practice Address - Country:US
Practice Address - Phone:270-706-5171
Practice Address - Fax:270-706-1357
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY585382086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program