Individual
KYLE B YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, RM DG412, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01071371A
IN
390200000X
Student in an Organized Health Care Education/Training Program
0580425596
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000820882
ANTHEM BCBS PIN
IN
05
—
201101240
—
IN
Enumeration date
04/29/2010
Last updated
03/16/2025
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