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NPI Code Detail

MEDICARE: KYLE WENTZ DO

MEDICARE: KYLE WENTZ DO
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
1208100000XPhysical Medicine & Rehabilitation Physician009501AZ

General Provider Information

NPI Number : 1114414885
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE WENTZ DO
Provider Business Mailing Address
First Line : 6930 S CIMARRON RD STE 260
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2135
Country : US
Telephone Number : 702-476-9700
Fax Number :
Provider Business Practice Location Address
First Line : 6930 S CIMARRON RD STE 260
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2135
Country : US
Telephone Number : 702-476-9700
Fax Number : 702-476-9138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2018
Last Update Date : 12/04/2025

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Directions to “ KYLE WENTZ DO” Practice Location

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