Individual
DR. KYLE JOSEPH FRITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3000
(417) 875-3695
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2004014291
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148380076
MEDICARE PTAN
MO
05
—
204027205
—
MO
Enumeration date
09/20/2006
Last updated
07/18/2013
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