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Individual

DR. KYLE BYRON WOMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4921 PARKVIEW PL, DIV NEURO AGING AND DEMENTIA, STE 6C, SAINT LOUIS, MO 63110-1032
(314) 286-1967
(314) 286-1985
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1967
(314) 286-1985

Taxonomy

Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
2020020119
MO
2084N0400X
Neurology Physician
Primary
2020020119
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200085730
MO
Enumeration date
04/27/2006
Last updated
04/17/2025
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