Healthcare Provider Details

I. General information

NPI: 1295362366
Provider Name (Legal Business Name): KYLE JARVIS MCATEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 08/22/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 MCCOMACK RD BLDG E
SCHOFIELD BARRACKS HI
96857
US

IV. Provider business mailing address

676 MCCOMACK RD BLDG E
SCHOFIELD BARRACKS HI
96857
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8423
  • Fax:
Mailing address:
  • Phone: 585-429-0484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberMD-23382-0
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-23382-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: