Healthcare Provider Details

I. General information

NPI: 1316942386
Provider Name (Legal Business Name): KEITH T CHESSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 9TH AVENUE
BESSEMER AL
35021
US

IV. Provider business mailing address

PO BOX 85378
CHICAGO IL
60689-5378
US

V. Phone/Fax

Practice location:
  • Phone: 205-481-7155
  • Fax:
Mailing address:
  • Phone: 336-274-6682
  • Fax: 336-274-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number24101
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME140637
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number301341
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number27218
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG163088
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number83578
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD82862
License Number StateSC
# 8
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number36159
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number64049
License Number StateCT
# 10
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.136633
License Number StateOH
# 11
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number320982
License Number StateLA
# 12
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD468633
License Number StatePA
# 13
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number24101
License Number StateAL
# 14
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101266336
License Number StateVA
# 15
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number29251
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: