Provider Demographics
NPI:1336322643
Name:KESSELL, JAMES LELAND (PD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LELAND
Last Name:KESSELL
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 HYNDMAN RD
Mailing Address - Street 2:
Mailing Address - City:HYNDMAN
Mailing Address - State:PA
Mailing Address - Zip Code:15545-7756
Mailing Address - Country:US
Mailing Address - Phone:814-842-3127
Mailing Address - Fax:301-777-0116
Practice Address - Street 1:11306 BEDFORD RD NE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6802
Practice Address - Country:US
Practice Address - Phone:301-777-1771
Practice Address - Fax:301-777-0116
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD09606OtherMARYLAND PHARMACISTS LICENSE