Provider Demographics
NPI:1588663199
Name:KESSLER, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KESSLER
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:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:ZUNI
Mailing Address - State:NM
Mailing Address - Zip Code:87327-0467
Mailing Address - Country:US
Mailing Address - Phone:505-782-4431
Mailing Address - Fax:505-782-7327
Practice Address - Street 1:ROUTE 301 NORTH B STREET
Practice Address - Street 2:US DHHS INDIAN HEALTH SERVICE
Practice Address - City:ZUNI
Practice Address - State:NM
Practice Address - Zip Code:87327-0467
Practice Address - Country:US
Practice Address - Phone:505-782-4431
Practice Address - Fax:505-782-7327
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1800201208000000X
NY180020-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000S2639Medicaid
NMS2639Medicaid
NM8HZ51AMedicare PIN
NM000S2639Medicaid