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General NPI Number Information
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NPI Number | 1831772441
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Entity Type | Individual
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Provider Name | KYLE GLEESON DPM
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Gender | Male
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 9011 N MERIDIAN ST STE 204
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5301
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Country | US
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Telephone | 317-218-4095
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Fax | 877-476-7125
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Provider Business Mailing Address
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Address Line | 5282 E 700 N
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City | GREENFIELD
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State | IN
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Zip | 46140-9199
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Country | US
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Telephone | 317-448-7679
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO4518
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License Number State | FL
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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 | 07001460A
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License Number State | IN
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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 | PR710
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License Number State | FL
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