Provider Demographics
NPI:1114487220
Name:AUSTIN, MATTHEW KYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:KYLE
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1120 WELLSTAR WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8952
Mailing Address - Country:US
Mailing Address - Phone:678-494-2500
Mailing Address - Fax:678-494-2629
Practice Address - Street 1:1120 WELLSTAR WAY STE 105
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30114-8952
Practice Address - Country:US
Practice Address - Phone:678-494-2500
Practice Address - Fax:678-494-2629
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92797207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine