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Organization
WALLINGFORD MEDICAL CLINIC, LLC
Active
Organization
WALLINGFORD MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REX K KESSLER MD (MD)
(610) 876-2300
Entity
Organization
Contact information
Practice address
2901 DUTTON MILL RD, STE 110, ASTON, PA 19014-2849
(610) 876-2300
(610) 876-3004
Mailing address
PO BOX 1897, BOOTHWYN, PA 19061-7897
(610) 876-2300
(610) 876-3004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD035193E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1612690
—
PA
01
—
19949
AETNA
PA
01
—
2060989001
KEYSTONE HEALTH PLAN EAST
PA
Enumeration date
07/18/2006
Last updated
10/03/2012
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