Healthcare Provider Details

I. General information

NPI: 1841653557
Provider Name (Legal Business Name): KYLE M GOBEIL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MAIN STREET 2ND FL, SUITE A
SPRINGFIELD MA
01199-1001
US

IV. Provider business mailing address

280 CHESTNUT STREET 2ND FL
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-2273
  • Fax: 413-794-0198
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number1018053
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: