Kersten, Keith A
Kersten, Keith A is an individual health care provider with primary practice located at 123 S 27Th Ave , Hattiesburg MS 39401-7136. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Kersten, Keith A can be contacted via phone (601) 450-3030.Contact Information
Primary practice address
123 S 27Th Ave
Hattiesburg MS 39401-7136
Phone: (601) 450-3030
Fax: (601) 450-3031
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 16793 | Mississippi |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 16793 | Mississippi |
Profile Details
| NPI number | 1861445108 |
|---|---|
| LBN Legal business name | Kersten, Keith A |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | May 14th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861445108 | NPPES |
| Mississippi | Other | P00718593 | RAILROAD MEDICARE |
| Mississippi | Other | 4122846 | RAILROAD MEDICARE |
| Mississippi | MEDICAID | 1145459 | RAILROAD MEDICARE |
| Mississippi | MEDICAID | 00124654 | RAILROAD MEDICARE |
| Mississippi | Other | 10980253 | RAILROAD MEDICARE |
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