Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KYLE RICHARD MARTIN
Active Sole ProprietorSports Medicine (EM) · CANTON, MO
Registration Details
- NPI Number
- 1679344030
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 12, 2024 (2.2743820371964 yrs)
- Last Updated
- Jan 12, 2024
- License
-
C054365002 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 COLLEGE HLCANTON, MO, 634351257Browse MO providers · Browse ZIP 63435
- Phone
- 5732886000
- Primary Specialty
-
Sports Medicine (EM)
207PS0010X
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.