Kenison, Kyle J

Kenison, Kyle J is an individual health care provider with primary practice located at 855 West 6Th South , Mountain Home ID 83647. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kenison, Kyle J can be contacted via phone (208) 587-2020.

Contact Information

Primary practice address
855 West 6Th South Mountain Home ID 83647
Fax: (208) 587-3349
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X MT 587 Montana

Profile Details

NPI number 1750370730
LBN Legal business name Kenison, Kyle J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Mar 15th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750370730 NPPES
Idaho MEDICAID 1750370730

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