Provider / Organization | NPI | Date Certified |
---|---|---|
KYLE THOMAS DEIVERT | 1922700301 | 2023-03-20 |
Kyle Thomas Deivert is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1922700301. Registration indicates Kyle Thomas Deivert is a provider of services with a specialization in Orthopaedic Surgery (Allopathic & Osteopathic Physicians, Orthopaedic Surgery) (Specialist Network, ) (Orthopaedic Surgery, Allopathic & Osteopathic Physicians) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
Entity Type | Individual |
Provider Name | Kyle Thomas Deivert |
Practice Office Address | 2500 N STATE ST JACKSON, MS US |
Practice Office Telephone | 6019841000 |
Mailing Address | 2500 N STATE ST JACKSON, MS 392164500 US |
Business Telephone | 6019841000 |
Address | City / State | Phone / Fax |
---|---|---|
1 Medical Center Blvd | Winston Salem, NC 271570001 | 3367160423 |
Code | Practice | License No State |
---|---|---|
207X00000X | Orthopaedic Surgery Allopathic & Osteopathic Physicians Orthopaedic Surgery Specialist Network Orthopaedic Surgery Allopathic & Osteopathic Physicians | T-5207
MS |
390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |