Provider Demographics
NPI:1326143785
Name:KESSLER, MAURY (OD)
Entity Type:Individual
Prefix:DR
First Name:MAURY
Middle Name:
Last Name:KESSLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4441 N 75TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3506
Mailing Address - Country:US
Mailing Address - Phone:480-947-4349
Mailing Address - Fax:480-423-9080
Practice Address - Street 1:4441 N 75TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3506
Practice Address - Country:US
Practice Address - Phone:480-947-4349
Practice Address - Fax:480-423-9080
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0902220OtherBLUE CROSS BLUE SHIELD
AZAZ0902220OtherBLUE CROSS BLUE SHIELD
AZZ115687Medicare PIN
AZAZ0902220OtherBLUE CROSS BLUE SHIELD