Provider Demographics
NPI:1427230622
Name:WIDMER, KYLE EMILY (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:EMILY
Last Name:WIDMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 21ST AVE S
Mailing Address - Street 2:A2200 MCN
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-2582
Mailing Address - Country:US
Mailing Address - Phone:615-322-8972
Mailing Address - Fax:
Practice Address - Street 1:1161 21ST AVE S
Practice Address - Street 2:A2200 MCN
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2582
Practice Address - Country:US
Practice Address - Phone:615-322-8972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201002207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine