Provider Demographics
NPI:1861529190
Name:E BUFORD KESLER DBA
Entity type:Organization
Organization Name:E BUFORD KESLER DBA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:BUFORD
Authorized Official - Last Name:KESLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:912-367-2000
Mailing Address - Street 1:375 A CITY CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513
Mailing Address - Country:US
Mailing Address - Phone:912-367-2000
Mailing Address - Fax:912-367-4112
Practice Address - Street 1:375 A CITY CIRCLE RD
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513
Practice Address - Country:US
Practice Address - Phone:912-367-2000
Practice Address - Fax:912-367-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000453103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty