Healthcare Provider Details

I. General information

NPI: 1942551106
Provider Name (Legal Business Name): JEROME ANDREW KESSLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 14TH AVE SW
SIDNEY MT
59270-3521
US

IV. Provider business mailing address

214 14TH AVE SW
SIDNEY MT
59270-3521
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2550
  • Fax: 406-488-2278
Mailing address:
  • Phone: 406-488-2550
  • Fax: 406-488-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5229
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number5229
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5229
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: