| Doctor Name: | KYLE MATTHEW MUMMEY |
| NPI Number: | 1831233881 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | MA052827 |
| Business Practice Address: | 19 Banks Ave Sugarloaf, PA - 182493700 |
| Business Phone Number: | 5707885104 |
| Business Fax Number: | |
| Mailing Address: | Po Box 197, SHEPPTON |
| State: | PA |
| Postal Code: | 182480197 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA052827 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |