Provider Demographics
NPI:1326215997
Name:KESSLER, TIMOTHY RAYMOND (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:RAYMOND
Last Name:KESSLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:8245 HOLLY RD
Mailing Address - Street 2:STE 101
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2443
Mailing Address - Country:US
Mailing Address - Phone:810-606-7500
Mailing Address - Fax:810-606-9600
Practice Address - Street 1:1352 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4185
Practice Address - Country:US
Practice Address - Phone:810-230-0001
Practice Address - Fax:810-230-0014
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601002988363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant