Provider Demographics
NPI:1295701795
Name:KESSLER, DIANA NOVAKOVIC (DO)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:NOVAKOVIC
Last Name:KESSLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 WHITE OAK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-3321
Mailing Address - Country:US
Mailing Address - Phone:423-285-6240
Mailing Address - Fax:877-276-2910
Practice Address - Street 1:195 WHITE OAK RD STE 100
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-3321
Practice Address - Country:US
Practice Address - Phone:423-285-6240
Practice Address - Fax:877-276-2910
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2354207Q00000X
TN02354207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ001061Medicaid
TN103I935264Medicare PIN