Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 236177 | MA |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD0000042138 | TN |
N | 207YP0228X | Pediatric Otolaryngology | MD42138 | TN |
NPI | 1104031053 |
---|---|
Provider Name | Dr. Kyle Mannion |
First Address | Nashville, TN 37232-8605 |
Second Address | Nashville, TN 37232-8605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2157870 | (05) | MA |