Provider Demographics
NPI:1508069352
Name:DEAN KYER MD, PLLC
Entity Type:Organization
Organization Name:DEAN KYER MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-766-4444
Mailing Address - Street 1:414 GREENWAY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1426
Mailing Address - Country:US
Mailing Address - Phone:304-766-4444
Mailing Address - Fax:304-766-4447
Practice Address - Street 1:414 GREENWAY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1426
Practice Address - Country:US
Practice Address - Phone:304-766-4444
Practice Address - Fax:304-766-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19792174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5600067000Medicaid
WVKY4020901Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
WV5600067000Medicaid