Basic Information
| Provider Information | |||||||||
| NPI: | 1457974347 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARVER | ||||||||
| FirstName: | KYLE | ||||||||
| MiddleName: | EDWARD | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 W CENTRAL PARK AVE | ||||||||
| Address2: | |||||||||
| City: | DAVENPORT | ||||||||
| State: | IA | ||||||||
| PostalCode: | 528041844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5634214400 | ||||||||
| FaxNumber: | 5634214445 | ||||||||
| Practice Location | |||||||||
| Address1: | 1345 W CENTRAL PARK AVE | ||||||||
| Address2: | |||||||||
| City: | DAVENPORT | ||||||||
| State: | IA | ||||||||
| PostalCode: | 528041844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5634214400 | ||||||||
| FaxNumber: | 5634214469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2020 | ||||||||
| LastUpdateDate: | 04/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R-11852 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.