Provider Demographics
NPI:1629261847
Name:WIRE, KYLE ROBERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ROBERT
Last Name:WIRE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7558 SUGARTREE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5430
Mailing Address - Country:US
Mailing Address - Phone:216-533-2402
Mailing Address - Fax:
Practice Address - Street 1:7558 SUGARTREE DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5430
Practice Address - Country:US
Practice Address - Phone:216-533-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003521213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery