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William Albert Ketterer

Internal Medicine

Allopathic & Osteopathic Physicians

1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638

PECOS Enrollment

This provider is enrolled in PECOS as WILLIAM KETTERER.

Based on the most recent information from CMS, provider William Albert Ketterer is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1518615111
Provider Type
Individual
Full Name
Ketterer, William Albert
Title
Dr.
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
3/13/2022
Last Updated
7/23/2025

Contact Information

Practice Location

1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638

(210) 292-6255

Unlisted Fax

Mailing Location

1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638

(210) 292-6255

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 0102208859 Virginia
Code 208D00000X	Description General Practice Allopathic & Osteopathic Physicians	License 0102208859 Virginia
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

William Albert Ketterer

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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