MEDICARE: DR. KYLE MANNION M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	236177	MA
2	207YP0228X	Pediatric Otolaryngology Physician	MD42138	TN
3	207Y00000X	Otolaryngology Physician	MD0000042138	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104031053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE MANNION M.D.

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:	615-936-2887

Provider Business Practice Location Address
First Line	:	MEDICAL CENTER EAST SOUTH TOWER
Second Line	:	1215 21ST AVENUE SOUTH, SUITE 7209
City	:	NASHVILLE
State	:	TN
Zip	:	37232-8605
Country	:	US
Telephone Number	:	615-322-6180
Fax Number	:	615-936-2887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	03/21/2022

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Directions to “ DR. KYLE MANNION M.D.” Practice Location

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