Healthcare Provider Details

I. General information

NPI: 1518968478
Provider Name (Legal Business Name): JEFFREY R KESSLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 26TH ST S RADIOLOGY DEPARTMENT
GREAT FALLS MT
59405-5161
US

IV. Provider business mailing address

PO BOX 9039
LONGVIEW TX
75608-9039
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8400
  • Fax: 903-663-7394
Mailing address:
  • Phone: 903-663-4800
  • Fax: 903-663-7394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7383
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: