Provider Demographics
NPI:1336671312
Name:KESSLER, STEPHEN II (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:KESSLER
Suffix:II
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 1:130 S 63RD ST STE 114
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1620
Mailing Address - Country:US
Mailing Address - Phone:480-981-2888
Mailing Address - Fax:480-641-9923
Practice Address - Street 1:130 S 63RD ST STE 114
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-981-2888
Practice Address - Fax:480-641-9923
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ62632207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program