| Doctor Name: | KYLE WILEBSKI |
| NPI Number: | 1003298316 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | RL 13722 |
| Business Practice Address: | 1130 W Michigan St # Fh204 Indianapolis, IN - 462025209 |
| Business Phone Number: | 3172740076 |
| Business Fax Number: | |
| Mailing Address: | 2813 Hayward Ave Apt D, BROWNSBURG |
| State: | IN |
| Postal Code: | 461120169 |
| Phone Number: | 7015208049 |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2015 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | RL 13722 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |