Provider Demographics
NPI:1679530307
Name:KESEG, DAVID PAUL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:KESEG
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 1:446 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2348
Mailing Address - Country:US
Mailing Address - Phone:513-834-7063
Mailing Address - Fax:513-873-1567
Practice Address - Street 1:126 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601
Practice Address - Country:US
Practice Address - Phone:513-834-7063
Practice Address - Fax:513-873-1567
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044161207QA0401X
OH35044161K207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00066458OtherRAILROAD MEDICARE
OHP00187423OtherMEDICARE RR/ADENA
OH000000543737OtherANTHEM BCBS
OH0406000Medicaid
OH000000139613OtherANTHEM/BCBS
OH000000315469OtherBCBS MEMORIAL
000000319941OtherBCBS
000000326488OtherBCBS CIRCLEVILLE
OH000000360660OtherBCBS
104734168OtherMICHIGAN MEDICAID
P00268378OtherRAIL ROAD MEDICARE
104734168OtherMICHIGAN MEDICAID
P00268378OtherRAIL ROAD MEDICARE
P00066458OtherRAILROAD MEDICARE
OHKE4122593Medicare PIN
KE0850309Medicare PIN
000000319941OtherBCBS
OHP00187423OtherMEDICARE RR/ADENA
OHKE4122596Medicare PIN