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Individual

KYLE ALLAN KENOBBIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1267 HIGHWAY 54 W STE 4200, FAYETTEVILLE, GA 30214-2112
(678) 829-1060
(678) 829-1099
Mailing address
1267 HIGHWAY 54 W STE 4200, FAYETTEVILLE, GA 30214-2112
(678) 829-1060
(678) 829-1099

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
03/31/2023
Last updated
04/01/2024
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