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

Dr. Wade Robert Keller, DO

Individual provider Dermatology Physician · NPI 1942402169

Dr. Wade Robert Keller, DO is a Micrographic Dermatologic Surgery (Mds) in Eagle, Idaho. Graduated from Arizona College of Osteopathic Medicine Mid Western University in 2005, 21 years ago. Practices with Keller Skin and Cancer Care PC, a 4-clinician group and accepts Medicare assignment. Licensed in Arizona and Idaho.

Years since qualifying
21
Trained at
Arizona College of Osteopathic Medicine Mid Western University
Licensed in
AZ, ID
In the registry since
2007
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1605 E Riverside Dr
Eagle, ID 83616-6237
Phone: (208) 939-6227
Fax: (208) 939-6442
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence O-0559 (ID)
Dermatology Physician Taxonomy 207N00000X · Licence 4692 (AZ)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence O-0559 (ID)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence O-0559 (ID)

Record details

NPI number1942402169
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 1, 2007
Last updated in NPPESNovember 3, 2022
Certification dateNovember 3, 2022
Mailing address1605 E Rverside Drive, Eagle, ID 83616

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Medical schoolARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated 2005 (21 years in practice)
Group practice Keller Skin And Cancer Care Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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