Provider Demographics
NPI:1619168036
Name:COMPTON, KYLE DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:DOUGLAS
Last Name:COMPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13531 SPRINGFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-1669
Mailing Address - Country:US
Mailing Address - Phone:804-818-3593
Mailing Address - Fax:
Practice Address - Street 1:4050 INNSLAKE DR STE 308
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3327
Practice Address - Country:US
Practice Address - Phone:804-521-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine