Healthcare Provider Details

I. General information

NPI: 1861124174
Provider Name (Legal Business Name): KYLE MICHAEL MEEK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981225 NEBRASKA MEDICAL CTR
OMAHA NE
68198-1225
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 402-836-9288
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number82357
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: