KYLE HAVERSTROM


Address: 200 S 20th St Ste B, Rogers, AR 72758-1100
Phone: 4796369393

KYLE HAVERSTROM (NPI# 1649791369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
292 AR Podiatric Medicine & Surgery Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
10800 Knights Rd, Philadelphia, PA 19114 2156125161

Office Location

Street Address 200 S 20TH ST STE B
City ROGERS
State AR
Zip Code 72758-1100

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407936388 Angela Lorraine Ayson Podiatrist 11 Halsted Cir Ste E, Rogers, AR 72756-3145 2006-10-16

Providers in the same taxonomy and state

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
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Competitor

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City ROGERS
Zip Code 72758

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Dataset Information

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.

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