Healthcare Provider Details

I. General information

NPI: 1053361402
Provider Name (Legal Business Name): BENJAMIN J KESSLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HOSPITAL CENTER BLVD
HILTON HEAD ISLAND SC
29926-2738
US

IV. Provider business mailing address

25 HOSPITAL CENTER BLVD
HILTON HEAD ISLAND SC
29926-2738
US

V. Phone/Fax

Practice location:
  • Phone: 843-689-8141
  • Fax: 843-689-8112
Mailing address:
  • Phone: 843-689-8141
  • Fax: 843-689-8112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number45851
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number600
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: