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General NPI Number Information
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NPI Number | 1164833612
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Entity Type | Individual
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Provider Name | JUSTIN KISTLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2014
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3300 TILLMAN DR FL 2
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City | BENSALEM
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State | PA
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Zip | 19020-2071
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Country | US
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Telephone | 800-321-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 1941 LIMESTONE RD STE 101
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City | WILMINGTON
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State | DE
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Zip | 19808-5413
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Country | US
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Telephone | 302-655-9494
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Fax | 302-691-1478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MT206253
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C1-0013633
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | MD467596
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License Number State | PA
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