Provider Demographics
NPI:1023531449
Name:KYLE GROUP PLLC
Entity type:Organization
Organization Name:KYLE GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:KYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-860-0360
Mailing Address - Street 1:PO BOX 5336
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-7504
Mailing Address - Country:US
Mailing Address - Phone:304-860-0360
Mailing Address - Fax:
Practice Address - Street 1:1007 S OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-5977
Practice Address - Country:US
Practice Address - Phone:304-860-0360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12360207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports MedicineGroup - Single Specialty