Healthcare Provider Details

I. General information

NPI: 1588663199
Provider Name (Legal Business Name): DAVID KESSLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROUTE 301 NORTH B STREET US DHHS INDIAN HEALTH SERVICE
ZUNI NM
87327-0467
US

IV. Provider business mailing address

PO BOX 467
ZUNI NM
87327-0467
US

V. Phone/Fax

Practice location:
  • Phone: 505-782-4431
  • Fax: 505-782-7327
Mailing address:
  • Phone: 505-782-4431
  • Fax: 505-782-7327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1800201
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number180020-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: