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Contact Information

KYLE J SMISEK, PA
1645 LYNDALE AVE N STE 103
FARIBAULT, MN55021-2935
 Phone: 507-334-1601
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KYLE J SMISEK · (Male)

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
  • MN License # 12563
Hospital affiliation(s)
  • NORTHFIELD HOSPITAL - (Acute Care)
    2000 NORTH AVENUE
    NORTHFIELD, MN 55057
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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