Provider Demographics
NPI:1912432782
Name:RENNER, KYLE M (MD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:M
Last Name:RENNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:250 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOISINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67544-1706
Mailing Address - Country:US
Mailing Address - Phone:620-653-5067
Mailing Address - Fax:620-653-5070
Practice Address - Street 1:252 W 9TH ST STE A
Practice Address - Street 2:
Practice Address - City:HOISINGTON
Practice Address - State:KS
Practice Address - Zip Code:67544-1700
Practice Address - Country:US
Practice Address - Phone:620-653-2386
Practice Address - Fax:620-653-4186
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-43889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine