Individual
BRANDON CASEY LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 495-6603
(651) 254-3123
Mailing address
420 DELAWARE ST SE, MMC 195, MINNEAPOLIS, MN 55455
(612) 625-6483
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
68476
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2017
Last updated
05/14/2021
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