Provider Demographics
NPI:1306855531
Name:KESSINGER, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:KESSINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E 6TH STREET
Mailing Address - Street 2:SUITE 309
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401
Mailing Address - Country:US
Mailing Address - Phone:850-785-9559
Mailing Address - Fax:850-785-1136
Practice Address - Street 1:801 E 6TH STREET
Practice Address - Street 2:SUITE 309
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401
Practice Address - Country:US
Practice Address - Phone:850-785-9559
Practice Address - Fax:850-785-1136
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049047208G00000X
OK10314208G00000X
CT019642208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77694OtherMEDICARE/BCBS GROUP NUMBE
FL04997ZOtherMEDICARE PROVIDER NUMBER
FL04997ZOtherBCBS PROVIDER NUMBER
FL04997ZOtherMEDICARE PROVIDER NUMBER