Provider Demographics
NPI:1912185380
Name:WILLIAM J KESSLER
Entity Type:Organization
Organization Name:WILLIAM J KESSLER
Other - Org Name:CAMEO OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-294-1159
Mailing Address - Street 1:2600 FAR HILLS AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1602
Mailing Address - Country:US
Mailing Address - Phone:937-294-1159
Mailing Address - Fax:937-294-8836
Practice Address - Street 1:2600 FAR HILLS AVE STE 15
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45419-1602
Practice Address - Country:US
Practice Address - Phone:937-294-1159
Practice Address - Fax:937-294-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-047082332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1275450001Medicare NSC