Kyle Jacob Havercroft in Coeur D Alene - Medical
Kyle Jacob Havercroft - NPI 1700063344
Kyle Jacob Havercroft is a Medical in Coeur D Alene, Idaho. Kyle Jacob Havercroft practices all healthcare services and medical treatments related to Medical. The NPI Number for Kyle Jacob Havercroft is 1700063344. The last update date is 2016-10-20.
Kyle Jacob Havercroft's current location address is 1107 W Ironwood Dr, Coeur D Alene, Idaho. You can contact this provider via phone number 2086677459 and fax number 2086672631. The mailing address for Kyle Jacob Havercroft is 1107 W Ironwood Dr, Coeur D Alene, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kyle Jacob Havercroft |
|---|---|
| Address | 1107 W Ironwood Dr, Coeur D Alene, Idaho |
| Phone Number | 2086677459 |
| Fax Number | 2086672631 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1700063344 |
|---|---|
| Provider Enumeration Date | 2008-01-25 |
| Last Updated Date | 2016-10-20 |
Provider Mailing Address Detail
| Address | 1107 W Ironwood Dr |
|---|---|
| City | Coeur D Alene |
| State | Idaho (ID) |
| Post Code | 838142604 |
| Phone Number | 2086677459 |
| Fax Number | 2086672631 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA-1313 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1083729438 | LINKED TO OSSM ORGANIZATION |
Post Comment/ Review Below
What is the Kyle Jacob Havercroft's 1700063344?
The Kyle Jacob Havercroft's NPI (National Provider Identifier) Number is 1700063344. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Kyle Jacob Havercroft's physical address?
The Kyle Jacob Havercroft is physically located at 1107 W Ironwood Dr, in the city of Coeur D Alene, ID, with the postal code 838142604.
What is the Kyle Jacob Havercroft's specialty and taxonomy code?
The Kyle Jacob Havercroft's specialty is Medical, and the corresponding taxonomy code is 363Am0700X.
On what date did Kyle Jacob Havercroft receive its 1700063344 assignment from the Centers for Medicare & Medicaid Services?
The Kyle Jacob Havercroft was assigned its 1700063344 on 2008-01-25, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Kyle Jacob Havercroft last refreshed?
The information related to the Kyle Jacob Havercroft, including its address, specialty, and other relevant details, was last updated on 2016-10-20.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY