Provider Demographics
NPI:1477281954
Name:METHER, KYLE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:METHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 DOUGLAS ST APT 309
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-4158
Mailing Address - Country:US
Mailing Address - Phone:951-310-5522
Mailing Address - Fax:
Practice Address - Street 1:720 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1925
Practice Address - Country:US
Practice Address - Phone:423-425-4706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN204C00000X204C00000X
TN207PS0010X207PS0010X
TN2083S0010X2083S0010X
TN2084S0010X2084S0010X
TN2081S0010X2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine
No2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine