Provider Demographics
NPI:1205013067
Name:DANIEL L. KESSLER, M. D., FACP, P.L.L.C.
Entity Type:Organization
Organization Name:DANIEL L. KESSLER, M. D., FACP, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-584-9500
Mailing Address - Street 1:14418 W MEEKER BLVD
Mailing Address - Street 2:#110
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5283
Mailing Address - Country:US
Mailing Address - Phone:623-584-9500
Mailing Address - Fax:623-584-4945
Practice Address - Street 1:14418 W MEEKER BLVD
Practice Address - Street 2:#110
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5283
Practice Address - Country:US
Practice Address - Phone:623-584-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ171851Medicaid
AZE74372Medicare UPIN
AZ171851Medicaid
Z65468Medicare PIN