Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DAVID STUART KYLLO, M.D.
Deactivated Sole ProprietorDAVID STUART KYLLO, M.D. is a Family Medicine healthcare provider located in EAGAN, Minnesota. NPI 1003811464 is deactivated in the NPPES registry. Verify at CMS.
Family Medicine · EAGAN, MN
This NPI has been deactivated.
The record was deactivated on March 17, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1003811464
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 14, 2005 (0.75616438356164 yrs)
- Last Updated
- Jul 8, 2007
- Deactivated
- Mar 17, 2006
- License
-
25450 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3460 WASHINGTON DRSTE 102EAGAN, MN, 551224301Browse MN providers · Browse ZIP 55122
- Phone
- 6514529240
- Fax
- 6514525440
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in EAGAN, MN
| Name | Credential | NPI |
|---|---|---|
| SUZANNE F PERMUTH | — | 1265416572 |
| JOHN P ROBROCK | — | 1285613992 |
| MICHELLE L KNIGHT | MD | 1376515536 |
| RAINA L YOUNG | MD | 1700858974 |
| DAVID J CACCAMO | MD | 1972575470 |
| MR. CHARLES E POGEMILLER SR. | MD | 1063489540 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.