Provider Demographics
NPI:1316935638
Name:KISER, GEORGE CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CRAIG
Last Name:KISER
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:PO BOX 1460
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-1460
Mailing Address - Country:US
Mailing Address - Phone:605-622-2876
Mailing Address - Fax:605-622-2804
Practice Address - Street 1:310 S PENN ST STE 202
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4553
Practice Address - Country:US
Practice Address - Phone:605-225-7326
Practice Address - Fax:605-622-2804
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13162174400000X
SD1459208800000X
NDLT19814208800000X
SD9355208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150185Medicaid
OR931220753OtherTAX ID
ORR105595Medicare ID - Type UnspecifiedPROVIDER ID
OR150185Medicaid