Individual
DR. KYLE CORNELIUS GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
18301 N 79TH AVE, BLDG F #168, GLENDALE, AZ 85308-8463
(623) 544-9090
(602) 603-5666
Mailing address
18301 N 79TH AVE, BLDG F #168, GLENDALE, AZ 85308-8463
(623) 544-9090
(602) 603-5666
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
9065045-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
9065045-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD-000927
AZ
Other
Enumeration date
06/20/2013
Last updated
06/18/2020
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