Healthcare Provider Details

I. General information

NPI: 1174684229
Provider Name (Legal Business Name): ADAM D. KESSLER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 SAINT JOHNS BLVD
JOPLIN MO
64804-1598
US

IV. Provider business mailing address

2901 SAINT JOHNS BLVD
JOPLIN MO
64804-1598
US

V. Phone/Fax

Practice location:
  • Phone: 304-956-0021
  • Fax: 630-358-6857
Mailing address:
  • Phone: 304-956-0021
  • Fax: 630-358-6857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101021236
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberE-17614
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number5101021236
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE-17614
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: