Individual
KYLE C GEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(765) 485-8000
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002491A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017233
—
IN
Enumeration date
05/24/2018
Last updated
06/22/2023
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