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Individual

KYLE STEVEN JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3023 S FORT AVE, SPRINGFIELD, MO 65807-5196
(417) 605-7100
(417) 771-3723
Mailing address
2864 S NETTLETON AVE, SPRINGFIELD, MO 65807-5970
(417) 874-1906
(417) 771-3723

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2000158907
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100178800A
OK
05
1518031699
MO
05
NP0487800
AR
01
P00700779
RAILROAD MEDICARE
MO
Enumeration date
11/20/2006
Last updated
02/04/2025
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