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Individual

SHANE W. KESLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA-C

Contact information

Practice address
7151 MARSH RD STE 150, INDIANAPOLIS, IN 46278-1631
(317) 208-3866
(317) 208-3867
Mailing address
7151 MARSH RD STE 150, INDIANAPOLIS, IN 46278-1631
(317) 208-3866
(317) 208-3867

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085004441
IL
363A00000X
Physician Assistant
Primary
10001547A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
062110013
MEDICARE PTAN
IN
Enumeration date
09/20/2012
Last updated
09/19/2022
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