Provider Demographics
NPI:1841298023
Name:KESSLER, REX KEITH (MD)
Entity type:Individual
Prefix:
First Name:REX
Middle Name:KEITH
Last Name:KESSLER
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 1897
Mailing Address - Street 2:
Mailing Address - City:BOOTHWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19061-7897
Mailing Address - Country:US
Mailing Address - Phone:610-876-2300
Mailing Address - Fax:610-876-3004
Practice Address - Street 1:2901 DUTTON MILL RD
Practice Address - Street 2:STE 110
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-2849
Practice Address - Country:US
Practice Address - Phone:610-876-2300
Practice Address - Fax:610-876-3004
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 020904E207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2769330/3545085OtherAETNA
PA001612715-0006Medicaid
PA2060988000OtherKEYSTONE EAST
PAKE49555Medicare ID - Type Unspecified
C28413Medicare UPIN