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Contact Information

CALEB KIESOW, MD
307 BOATNER RD
EGLIN AFB, FL32542-1282
 Phone: 850-883-8600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for CALEB KIESOW · (Male)

NPI Number 1033704226
Status Active
Credentials MD
Entity Individual
Enumeration date 03/09/2021
Last updated 11/05/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2023007981
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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