Provider Demographics
NPI:1255726295
Name:KILE, AMANDA J (DO)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:J
Last Name:KILE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:SCHNECK SPECIALTY ASSOCIATES
Mailing Address - Street 2:225 S PINE ST, STE 300
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274
Mailing Address - Country:US
Mailing Address - Phone:812-523-7893
Mailing Address - Fax:812-523-7896
Practice Address - Street 1:SCHNECK SPECIALTY ASSOCIATES
Practice Address - Street 2:225 S PINE ST, STE 300
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274
Practice Address - Country:US
Practice Address - Phone:812-523-7893
Practice Address - Fax:812-523-7896
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN02005336A207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program