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Individual

DR. KEITH A KERSTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
123 S 27TH AVE, HATTIESBURG, MS 39401-7136
(601) 450-3030
(601) 450-3031
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-3700
(601) 450-2493

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
16793
MS
207Q00000X
Family Medicine Physician
Primary
16793
MS
207Q00000X
Family Medicine Physician
328332
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124654
MS
01
10980253
CAQH ID NUMBER
MS
05
1145459
LA
01
4122846
AETNA
MS
01
P00718593
RAILROAD MEDICARE
MS
Enumeration date
05/18/2006
Last updated
09/14/2025
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