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NPI Code Detail

MEDICARE: MR. MARK ROBERT KESTLER R.PH.

MEDICARE:  MR. MARK ROBERT KESTLER  R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03215192OH

General Provider Information

NPI Number : 1598971145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK ROBERT KESTLER R.PH.
Provider Business Mailing Address
First Line : 6990 CLAWSON RIDGE CT
Second Line :
City : LIBERTY TWP
State : OH
Zip : 45011-9118
Country : US
Telephone Number : 513-844-1234
Fax Number :
Provider Business Practice Location Address
First Line : 10828 KENWOOD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-2812
Country : US
Telephone Number : 513-792-7080
Fax Number : 513-792-3838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 07/08/2007

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Directions to “ MR. MARK ROBERT KESTLER R.PH.” Practice Location

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