MEDICARE: WILLIAM J KESSLER

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
1	332H00000X	Eyewear Supplier	35-047082	OH

General Provider Information

NPI Number	:	1912185380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM J KESSLER

Provider Business Mailing Address
First Line	:	2600 FAR HILLS AVE STE 15
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45419-1602
Country	:	US
Telephone Number	:	937-294-1159
Fax Number	:	937-294-8836

Provider Business Practice Location Address
First Line	:	2600 FAR HILLS AVE STE 15
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45419-1602
Country	:	US
Telephone Number	:	937-294-1159
Fax Number	:	937-294-8836

Authorized Official
Title or Position	:	BILLING MANGER
Name	:	CHERI HALL
Credential	:
Telephone Number	:	937-294-1159

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	02/07/2008

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Directions to “WILLIAM J KESSLER ” Practice Location

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