Provider Demographics
NPI:1679351720
Name:FITZGERALD, KYLE JAMES (DO)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:JAMES
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD # MS 2005
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-1886
Practice Address - Country:US
Practice Address - Phone:913-588-6124
Practice Address - Fax:913-588-7540
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2025-06-21
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Provider Licenses
StateLicense IDTaxonomies
KS94-12317208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery