Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keller Skin & Cancer Care PC

Organization Dermatology Physician · NPI 1649543323

Keller Skin & Cancer Care PC is a Dermatology Physician in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2012.

Licensed in
ID
In the registry since
2012
Specialties on file
4
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1605 E Riverside Dr
Eagle, ID 83616
Phone: (208) 939-6227
Fax: (208) 939-6442
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
Dermatology Physician Taxonomy 207N00000X · Licence O-0559 (ID)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1649543323
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wade Keller — President · (208) 939-6227
Other names Keller Skin Care; Keller Skin Care
NPI enumeratedFebruary 11, 2012
Last updated in NPPESNovember 3, 2022
Certification dateNovember 3, 2022
Mailing address1605 E Riverside Dr, Eagle, ID 83616-6237

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