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General NPI Number Information
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NPI Number | 1629223110
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Entity Type | Individual
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Provider Name | KYLE R. YORGASON D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1075 N CURTIS RD STE 300
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City | BOISE
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State | ID
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Zip | 83706-1348
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Country | US
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Telephone | 208-302-3100
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Fax | 208-302-3155
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Provider Business Mailing Address
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Address Line | 3340 E GOLDSTONE DR
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City | MERIDIAN
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State | ID
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Zip | 83642-1026
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Country | US
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Telephone | 208-367-5170
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Fax | 208-367-5180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC006038
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006038
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | P-255
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P-255
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License Number State | ID
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