Provider Demographics
NPI:1497836902
Name:HULER, KYLENE K (MD)
Entity Type:Individual
Prefix:
First Name:KYLENE
Middle Name:K
Last Name:HULER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5250 E US 36
Mailing Address - Street 2:SUITE 210
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123
Mailing Address - Country:US
Mailing Address - Phone:317-718-1355
Mailing Address - Fax:317-718-1358
Practice Address - Street 1:5250 E US HIGHWAY 36
Practice Address - Street 2:SUITE 210
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9199
Practice Address - Country:US
Practice Address - Phone:317-718-1355
Practice Address - Fax:317-718-1358
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN10434572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ING61754Medicare UPIN
IN345440BMedicare ID - Type UnspecifiedMEDICARE