Individual
KYLE R. SPEAKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1391 N BALDWIN AVENUE, MARION, IN 46952-1913
(765) 660-7900
(765) 671-7751
Mailing address
330 N WABASH, STE G20, MARION, IN 46952-2600
(765) 660-7616
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11017446A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001021719
ANTHEM
IN
Enumeration date
04/08/2013
Last updated
10/19/2020
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