Provider Demographics
NPI:1881956001
Name:KEESLING, ADAM D (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:D
Last Name:KEESLING
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 1:510 W RADIO LN
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-4011
Mailing Address - Country:US
Mailing Address - Phone:620-442-2100
Mailing Address - Fax:620-442-8945
Practice Address - Street 1:510 W RADIO LN
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005
Practice Address - Country:US
Practice Address - Phone:620-442-2100
Practice Address - Fax:620-442-8945
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-38281207Q00000X
IN01073418A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-38281OtherKANSAS STATE LICENSE
IN201087570Medicaid
IN201087570Medicaid