Individual
KYLE SAMBLANET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-3313
Mailing address
4076 NEELY ROAD, FORT WAINWRIGHT, AK 99703
(907) 361-5974
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-19968
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD-19968
MEDICAL LICENSE
HI
Enumeration date
03/30/2017
Last updated
07/07/2022
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