Healthcare Provider Details

I. General information

NPI: 1710071295
Provider Name (Legal Business Name): KYLE L.R. SPERLING PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 S CEDAR ST
LANSING MI
48910-3152
US

IV. Provider business mailing address

PO BOX 30161
LANSING MI
48909-7661
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-4302
  • Fax:
Mailing address:
  • Phone: 517-887-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601004878
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: