NPI Profile for KYLE J SMISEK in FARIBAULT, MN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1336653864 |
|
| Status | Active | |
| Credentials | PA (Physician Assistant) | |
| Entity | Individual | |
| Enumeration date | 11/20/2017 | |
| Last updated | 11/20/2017 - About 9 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KYLE J SMISEK
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