Dettbarn, Kyle James

Dettbarn, Kyle James is an individual health care provider with primary practice located at 3802 Oakwood Mall Dr , Eau Claire WI 54701-3016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Dettbarn, Kyle James can be contacted via phone (715) 839-9280.

Contact Information

Primary practice address
3802 Oakwood Mall Dr Eau Claire WI 54701-3016
Phone: (715) 839-9280
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 45848 Wisconsin
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 45848 Wisconsin

Profile Details

NPI number 1558301465
LBN Legal business name Dettbarn, Kyle James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Dec 22nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558301465 NPPES
Wisconsin MEDICAID 34400700

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