Provider Demographics
NPI:1609393529
Name:HUGHES, KYLE DEVIN (PT)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:DEVIN
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 SOUTH YALE AVE
Mailing Address - Street 2:SUITE 500 ATTN MELISSA LAYWELL
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3319
Mailing Address - Country:US
Mailing Address - Phone:918-502-8013
Mailing Address - Fax:918-502-8002
Practice Address - Street 1:6585 S YALE AVE STE 445
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-9703
Practice Address - Country:US
Practice Address - Phone:918-494-1471
Practice Address - Fax:918-494-1494
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist