Individual
KYLE STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3125 S SCATTERFIELD RD STE 210, ANDERSON, IN 46013
(765) 298-4311
(765) 298-4312
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
02005437A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
02005437A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015335
—
IN
Enumeration date
04/04/2012
Last updated
11/27/2023
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