Organization
DAVID A. KYLE OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ALAN KYLE O.D. (CEO)
(906) 228-8808
Entity
Organization
Contact information
Practice address
1055 W BARAGA AVE, MARQUETTE, MI 49855-4068
(906) 228-8808
(906) 228-9022
Mailing address
1055 W BARAGA AVE, MARQUETTE, MI 49855-4068
(906) 228-8808
(906) 228-9022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003683
MI
152WC0802X
Corneal and Contact Management Optometrist
4901003683
MI
152WP0200X
Pediatric Optometrist
4901003683
MI
152WS0006X
Sports Vision Optometrist
4901003683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130001809
WEA
MI
01
—
900E265210
BCBS
MI
05
—
94-3319568
—
MI
Enumeration date
04/22/2008
Last updated
05/28/2008
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