Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 2011014616 | MO |
N | 222Z00000X | Podiatrist | 2011014616 | MO |
Y | 213ES0103X | Foot & Ankle Surgery | 2011014616 | MO |
NPI | 1013246701 |
---|---|
Provider Name | Dr. Kyle Fiala |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2009 |
Last Update Date | 09/05/2019 |