Etzkorn, Kyle P

Etzkorn, Kyle P is an individual health care provider with primary practice located at 4800 Belfort Rd , Jacksonville FL 32256-6004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Etzkorn, Kyle P can be contacted via phone (904) 398-7205.

Contact Information

Primary practice address
4800 Belfort Rd Jacksonville FL 32256-6004
Phone: (904) 398-7205
Fax: (904) 396-4047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME0071063 Florida

Profile Details

NPI number 1598761439
LBN Legal business name Etzkorn, Kyle P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Feb 5th, 2021 - about 3 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 1598761439 NPPES
Florida MEDICAID 253739700

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