Will this fit my left front door without modification?

Yes. This handle mounts at the factory attachment points on the driver-side door. Bolt it straight in using the existing holes.

Does this come with fasteners?

The handle assembly itself is included. Fasteners are not confirmed — verify you have the correct bolts before installation, or source them separately if needed.

Can I use this with the keyhole or does it require additional parts?

The keyhole is built in. You insert your key directly into the handle to unlock the door — no extra mechanisms needed.