Provider Demographics
NPI:1134647464
Name:TORRES, KYLE ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:ELIZABETH
Last Name:TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KYLE
Other - Middle Name:ELIZABETH
Other - Last Name:KILLEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1418 SCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1424
Mailing Address - Country:US
Mailing Address - Phone:404-446-1340
Mailing Address - Fax:404-727-0045
Practice Address - Street 1:1418 SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1424
Practice Address - Country:US
Practice Address - Phone:404-446-1340
Practice Address - Fax:404-727-0045
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA97736207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine