# KYLE RICKNER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528429669
- **Authorized official:** KYLE RICKNER M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (405) 265-2778

## Contact information

- **Practice address:** 11 PALM AVE, YUKON, OK 73099-5645
- **Practice address phone:** (405) 350-5140
- **Mailing address:** 1820 COMMONS CIRCLE, SUITE A, YUKON, OK 73099-9518
- **Mailing address phone:** (405) 265-2778
- **Mailing address fax:** (405) 494-7274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/17/2016
- **Last updated:** 03/17/2016