Provider Demographics
NPI:1205269248
Name:KESSLER, FRED OTTO IV (PHARMD)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:OTTO
Last Name:KESSLER
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4412
Mailing Address - Country:US
Mailing Address - Phone:912-355-0122
Mailing Address - Fax:912-355-6620
Practice Address - Street 1:911 E 65TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4412
Practice Address - Country:US
Practice Address - Phone:912-355-0122
Practice Address - Fax:912-355-6620
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14175183500000X
GARPH27395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist