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General NPI Number Information
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NPI Number | 1487644662
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Entity Type | Individual
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Provider Name | WILLIAM T KESSELRING JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 500 PLAZA CT STE B
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-8262
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Country | US
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Telephone | 570-421-8526
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Fax | 570-421-7899
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Provider Business Mailing Address
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Address Line | 206 E BROWN ST POCONO HEALTHCARE MANAGEMENT
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3006
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Country | US
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Telephone | 570-420-4951
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Fax | 570-476-3754
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD024311E
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License Number State | PA
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