IndividualActive
Kyle Martin
NPI 1679344030 · Sports Medicine (Emergency Medicine) Physician · Canton, MO
Provider details
- NPI number
- 1679344030
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- C054365002 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1 College Hl
Canton, MO 63435-1257
Phone: (573) 288-6000
Approximate (ZIP-level) locationGet directions
Mailing address
1 College Hl
Canton, MO 63435-1299
Registry dates
- Enumerated
- 2024-01-12
- Last updated
- 2024-01-12
- Certified
- 2024-01-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.