Provider Demographics
NPI:1851549901
Name:HAZELWOOD, KYLE J (MD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:J
Last Name:HAZELWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4048 CEDAR BLUFF DR STE 1
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8895
Mailing Address - Country:US
Mailing Address - Phone:231-347-5155
Mailing Address - Fax:231-668-4082
Practice Address - Street 1:4048 CEDAR BLUFF DR STE 1
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8895
Practice Address - Country:US
Practice Address - Phone:231-347-5155
Practice Address - Fax:231-668-4082
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2024-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ46201207X00000X
IL125052518207X00000X
CA111422207X00000X
MI4301511405207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery