| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KYLE RONALD GEORGE | 1225220643 | 2024-07-05 |
Kyle R George [M] graduated in 2008 and primarily specializes in Physician Assistant.
Kyle Ronald George is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225220643. Registration indicates Kyle Ronald George is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Medical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Medical, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| PECOS ID | 1557422052 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Kyle Ronald George P.A.-C |
| Practice Office Address | 801 POLE LINE RD W TWIN FALLS, ID US |
| Practice Office Telephone | 2088148150 |
| Practice Office Fax | 2087323112 |
| Mailing Address | 190 E BANNOCK ST BOISE, ID 837126241 US |
| Code | Practice | License No State |
|---|---|---|
| 363AM0700X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Medical All Other Specialties & Provider Types Physician Assistant Medical Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | PA-775
ID |