Individual
DR. KYLE J ERICSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29000 CENTER RIDGE RD STE 400, WESTLAKE, OH 44145-5219
(440) 835-8000
Mailing address
2350 CHARNEY RD, UNIVERSITY HEIGHTS, OH 44118-3720
(216) 213-2169
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35.142520
OH
208800000X
Urology Physician
57.026312
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0454660
—
OH
Enumeration date
05/01/2014
Last updated
02/07/2022
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