Basic Information
Provider Information
NPI: 1649533845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARCHES
FirstName: KYLE
MiddleName: EDWARD
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3635 VISTA AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631102539
CountryCode: US
TelephoneNumber: 3145778000
FaxNumber:  
Practice Location
Address1: 3635 VISTA AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631102539
CountryCode: US
TelephoneNumber: 3145778000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2012
LastUpdateDate: 07/08/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2015013976MOY Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X125061423ILN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home