Individual
KYLE AARON LITTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845-1673
(260) 425-6780
(260) 373-9925
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01076395A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201258780
—
IN
Enumeration date
05/22/2012
Last updated
10/02/2023
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