Provider Demographics
NPI:1124373287
Name:SCHAEFER, KYLE (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:SCHAEFER
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Gender:M
Credentials:MS, PA-C
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2200NENEFF RD 200
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4281
Mailing Address - Country:US
Mailing Address - Phone:541-382-3344
Mailing Address - Fax:541-382-1681
Practice Address - Street 1:181 W MEADOW DR STE 400
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657-5058
Practice Address - Country:US
Practice Address - Phone:970-476-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2015-08-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical