Provider Demographics
NPI:1790072395
Name:EASH, KYLE J (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:J
Last Name:EASH
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:1008 S SPRING AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-617-3339
Mailing Address - Fax:314-256-3364
Practice Address - Street 1:2315 DOUGHERTY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3379
Practice Address - Country:US
Practice Address - Phone:314-617-2200
Practice Address - Fax:314-617-2196
Is Sole Proprietor?:No
Enumeration Date:2011-07-02
Last Update Date:2024-04-03
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Provider Licenses
StateLicense IDTaxonomies
MO2015018653207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology