Provider Demographics
NPI:1821351891
Name:VISSER, TESSA V (MD)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:V
Last Name:VISSER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:V
Other - Last Name:BANDHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1110 SAINT MARYS RD
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-4176
Mailing Address - Country:US
Mailing Address - Phone:785-762-2585
Mailing Address - Fax:
Practice Address - Street 1:1110 SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-4176
Practice Address - Country:US
Practice Address - Phone:785-762-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-40302208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics