Individual
DR. KYLE JAMES DETTBARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3802 OAKWOOD MALL DR, EAU CLAIRE, WI 54701-3016
(715) 839-9280
Mailing address
2403 FOLSOM ST, EAU CLAIRE, WI 54703-2435
(715) 552-9784
(715) 835-6370
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
45848
WI
207RP1001X
Pulmonary Disease Physician
Primary
45848
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34400700
—
WI
Enumeration date
06/08/2006
Last updated
04/10/2026
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