Healthcare Provider Details

I. General information

NPI: 1508279738
Provider Name (Legal Business Name): LACEY KESSLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 W 5TH ST
BOWDLE SD
57428
US

IV. Provider business mailing address

8001 W 5TH ST
BOWDLE SD
57428
US

V. Phone/Fax

Practice location:
  • Phone: 605-285-6146
  • Fax: 605-285-6410
Mailing address:
  • Phone: 605-285-6146
  • Fax: 605-285-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10531
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: