Provider Demographics
NPI:1497101729
Name:KIESSLING, JOHN WILLIS (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIS
Last Name:KIESSLING
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:108 W JEFFERSON ST APT 809
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2524
Mailing Address - Country:US
Mailing Address - Phone:215-796-5979
Mailing Address - Fax:
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-507-8473
Practice Address - Fax:760-507-8316
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2025-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A16987207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery