Provider Demographics
NPI:1235176843
Name:KIESSLING, DAVID J (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:KIESSLING
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:4200 N RODNEY PARHAM RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2461
Mailing Address - Country:US
Mailing Address - Phone:501-534-8888
Mailing Address - Fax:501-534-8891
Practice Address - Street 1:4200 N RODNEY PARHAM RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-2461
Practice Address - Country:US
Practice Address - Phone:501-534-8888
Practice Address - Fax:501-534-8891
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2011-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR246213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5AH89C803Medicare PIN