Individual
JAY J KIESSLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5401 PEACH ST STE 3600, ERIE, PA 16509-2601
(814) 868-2170
(814) 868-2108
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
(814) 868-2522
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD040102L
PA
2086S0129X
Vascular Surgery Physician
Primary
MD040102L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026721580002
—
PA
Enumeration date
10/10/2006
Last updated
04/06/2023
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