Individual
STEPHEN RAY KESSINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 731-2511
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 731-2511
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
O-0781
ID
390200000X
Student in an Organized Health Care Education/Training Program
OT013461
PA
Other
Enumeration date
07/02/2010
Last updated
07/29/2014
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