MEDICARE: KYLE PARKISON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1306217419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE PARKISON

Provider Business Mailing Address
First Line	:	PO BOX 4
Second Line	:
City	:	PARKER CITY
State	:	IN
Zip	:	47368-0004
Country	:	US
Telephone Number	:	765-625-0295
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 N LOWELL ST
Second Line	:
City	:	PARKER CITY
State	:	IN
Zip	:	47368-9301
Country	:	US
Telephone Number	:	765-748-0748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2015
Last Update Date	:	10/08/2024

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Directions to “ KYLE PARKISON ” Practice Location

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