Provider Demographics
NPI:1225441660
Name:LESTER, KYLE MATTHEW (DO)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:MATTHEW
Last Name:LESTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224-D CORNWALL STREET, NW.
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-1987
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:614-944-4750
Practice Address - Street 1:19415 DEERFIELD AVENUE, SUITE 112
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-724-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15935208800000X
OH34.014685208800000X
VA0102207451208800000X
PAOT015671390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1225441660Medicaid