Caleb Kiesow, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2023007981 Issued in MO

Practice address

307 Boatner Rd
Eglin Afb, FL 32542-1282

Phone

(850) 883-8600

NPI assigned

Mar 9, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1033704226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421282",
            "telephone_number": "850-883-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421282",
            "telephone_number": "850-883-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESOW",
        "first_name": "CALEB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2023007981",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MO",
            "license": "2023007981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Kelly, DMD
• Kestraunda Kelly, FNP
• Ngoc Kelsch, DENTAL HYGIENIST
• Andrea G. Kern, RDH
• Abigail Kiesow, MD
• Dereje A Kifle
• Jonah R Kincaid
• Scott Alexander King, M.D.
• Jamie Lynn Krassow, MD
• Sean David Krieger, DO

• Family Medicine Physician in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.