Individual
KYLE STEVEN DEUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
110 PROFESSIONAL CT, JESUP, GA 31545-0044
(912) 427-0800
Mailing address
PO BOX 1334, JESUP, GA 31598-1334
(912) 427-0800
(912) 427-6029
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007290
GA
363AS0400X
Surgical Physician Assistant
25MP00080100
NJ
Other
Enumeration date
07/26/2006
Last updated
01/03/2017
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