KYLE HAVERSTROM (NPI# 1649791369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649791369 |
Entity Type | Individual |
Full Name | KYLE HAVERSTROM |
Credential | DPM |
Practice Address |
200 S 20th St Ste B Rogers AR 72758-1100 |
Practice Telephone | 4796369393 |
Mailing Telephone | 4796369393 |
Enumeration Date | 2017-07-03 |
Last Update Date | 2020-09-10 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
292 | AR | Podiatric Medicine & Surgery Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
10800 Knights Rd, Philadelphia, PA 19114 | 2156125161 |
Street Address |
200 S 20TH ST STE B |
City | ROGERS |
State | AR |
Zip Code | 72758-1100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417588690 | Premier Hospitalists of Nwa, Pllc | Hospitalist | 4313 S Pleasant Crossing Blvd, Rogers, AR 72758 | 2020-01-28 |
1447893235 | Kelsey Elizabeth Sutton | Speech-Language Pathologist | 2100 West Perry Rd, Rogers, AR 72758 | 2019-10-24 |
1447700299 | Shannon Kaima | Physician Assistant | 5900 W Stoney Brook Rd Apt 14207, Rogers, AR 72758 | 2016-10-05 |
1801345426 | The Exclusive Eye, Pllc | Optometrist | 5100 W Pauline Whitaker Parkway, 107, Rogers, AR 72758 | 2016-09-23 |
1780063909 | Nicholas Honea | Nurse Anesthetist, Certified Registered | 4600 Centre Court, Rogers, AR 72758 | 2015-05-20 |
1811388945 | Amanda M Hawes | Physician Assistant | 1000 S. 52nd Street, Rogers, AR 72758 | 2015-02-11 |
1316354087 | Natalie Horine | Chiropractor | 4305 S Pleasant Crossing Blvd Ste 102, Rogers, AR 72758 | 2014-07-15 |
1205248903 | Clyde K. Tempel | Registered Nurse | 2100 W. New Hope Rd. #1804, Rogers, AR 72758 | 2014-05-29 |
1548692445 | Becky Tadlock Ross | Pharmacist | 1766 West Laurel, Rogers, AR 72758 | 2013-08-01 |
1497190797 | Medical Associates of Northwest Arkansas Pa | Pediatrics | 3730 S Pinnacle Hills Pkwy Ste 3, Rogers, AR 72758 | 2013-05-01 |
Find all providers in zip 72758 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407936388 | Angela Lorraine Ayson | Podiatrist | 11 Halsted Cir Ste E, Rogers, AR 72756-3145 | 2006-10-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609288984 | Aaron Teufel | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703 | 2014-05-21 |
1568716744 | Spencer Lewis Mortensen | Podiatrist | 1500 Dodson Ave Ste 260, Fort Smith, AR 72901-5179 | 2012-11-09 |
1982968574 | Adam Lloyd Bingham | Podiatrist | 1713 W Main St, Russellville, AR 72801-2721 | 2012-06-27 |
1477881092 | Bradley Footcare LLC | Podiatrist | 116 W Tyler Ave Ste B, West Memphis, AR 72301-4221 | 2009-11-19 |
1114160389 | Jesse H. Bradley Jr. | Podiatrist | 116 W Tyler Ave, Suite B, West Memphis, AR 72301-4221 | 2009-04-16 |
1154571495 | Mid-south Foot & Ankle Clinic P C | Podiatrist | 302 S Rhodes St, West Memphis, AR 72301-4215 | 2008-09-23 |
1235314147 | Stephanie A. Roth | Podiatrist | 703 W Main St, Russellville, AR 72801-3616 | 2008-01-09 |
1144341827 | Carlotta Monique Wells | Podiatrist | 1132 Malvern Ave, Hot Springs, AR 71901-6347 | 2007-04-02 |
1295743557 | Crotty Foot Clinic P A | Podiatrist | 6600 Rogers Ave, Fort Smith, AR 72903-4064 | 2006-08-03 |
1104842814 | Joseph M. Lacava | Podiatrist | 3339 Central Ave, Suite F, Hot Springs, AR 71913-6138 | 2006-07-14 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.