Healthcare Provider Details

I. General information

NPI: 1982763074
Provider Name (Legal Business Name): JOHN KESSELS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 HIGHWAY 1085
COVINGTON LA
70433-7227
US

IV. Provider business mailing address

PO BOX 1725
KENNER LA
70063-1725
US

V. Phone/Fax

Practice location:
  • Phone: 985-845-9000
  • Fax: 985-845-9003
Mailing address:
  • Phone: 985-845-9000
  • Fax: 985-845-9003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number021259
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: