DR. KEITH A KERSTEN (NPI# 1861445108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861445108 |
Entity Type | Individual |
Full Name | DR. KEITH A KERSTEN |
Credential | D.O. |
Practice Address |
123 S 27th Ave Hattiesburg MS 39401-7136 |
Mailing Address |
Po Box 1729 Hattiesburg MS 39403-1729 |
Practice Telephone | 6014503030 |
Practice Fax Number | 6014503031 |
Mailing Telephone | 6015453700 |
Mailing Fax Number | 6014502493 |
Enumeration Date | 2006-05-18 |
Last Update Date | 2019-05-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | 16793 | MS | Allopathic & Osteopathic Physicians |
Y | 207Q00000X | Family Medicine | 16793 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | RAILROAD MEDICARE | P00718593 | 01 |
MS | 00124654 | 05 | |
MS | CAQH ID NUMBER | 10980253 | 01 |
LA | 1145459 | 05 | |
MS | AETNA | 4122846 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
66 Old Airport Rd, Hattiesburg, MS 394018382 | 6015447500 | 6015447524 |
Street Address |
123 S 27TH AVE |
City | HATTIESBURG |
State | MS |
Zip Code | 39401-7136 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
Find all providers in zip 39401 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679053979 | Hattiesburg Clinic, Pa | Family Medicine | South 28th Avenue Family Medicine, 1101 South 28th Avenue, Suite C, Hattiesburg, MS 39402 | 2018-08-16 |
1699267625 | Forrest County General Hospital | Family Medicine | 415 S 28th Ave Fl 1, Hattiesburg, MS 39401-7246 | 2018-06-05 |
1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
1316390289 | Jenisus Marie Owens | Family Medicine | 5909 U S Highway 49 Ste 20, Hattiesburg, MS 39402-2860 | 2016-07-15 |
1760877948 | Jason Fisher | Family Medicine | 1101 S 28th Ave Ste C, Hattiesburg, MS 39402 | 2015-04-03 |
1871829929 | Adeline After-hour Care, LLC | Family Medicine | 1307 Adeline St, Hattiesburg, MS 39401-5028 | 2009-10-26 |
1366691644 | Stephen Marc Wascomb | Family Medicine | 2556 Old Highway 24, Hattiesburg, MS 39402-8311 | 2008-09-11 |
1396902409 | Tonya G Creech | Family Medicine | 3700 Hardy St Ste 10, Hattiesburg, MS 39402-1614 | 2008-05-19 |
1265631907 | Ikechukwu Okorie | Family Medicine | 908 W Pine St, Hattiesburg, MS 39401-4262 | 2007-07-13 |
1740374255 | Stephen Massey | Family Medicine | 6600 Us Hwy 98, Suite B, Hattiesburg, MS 39402 | 2006-10-02 |
Find all providers in HATTIESBURG |
City | HATTIESBURG |
Zip Code | 39401 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.