Provider Demographics
NPI:1437344587
Name:PLOEHN, KYLE W (PA-C)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:W
Last Name:PLOEHN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:310 N. MAIN STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1807
Mailing Address - Country:US
Mailing Address - Phone:734-222-8200
Mailing Address - Fax:734-222-8202
Practice Address - Street 1:5161 B DR S
Practice Address - Street 2:SUITE A
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9345
Practice Address - Country:US
Practice Address - Phone:269-969-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601003960363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical