Healthcare Provider Details

I. General information

NPI: 1710894571
Provider Name (Legal Business Name): KYLIE BECHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BROOKSTONE CENTRE PKWY STE 500
COLUMBUS GA
31904-9269
US

IV. Provider business mailing address

808 CALHOUN RD
SMITHS STATION AL
36877-2407
US

V. Phone/Fax

Practice location:
  • Phone: 706-568-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: