Kelly, Kyle Anderson

Kelly, Kyle Anderson is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Kelly, Kyle Anderson can be contacted via phone (903) 531-4500.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 531-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X N9575 Texas

Profile Details

NPI number 1023284213
LBN Legal business name Kelly, Kyle Anderson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2008
Last updated Oct 13th, 2014 - about 11 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 1023284213 NPPES
Texas MEDICAID 305265601
Texas Other P01083623
Texas Other 75-2616977-042
Texas Other 8V5226

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