KAYLE ELIZABETH SOUTHERLAND


Address: 307 Boatner Rd, Eglin Afb, FL 32542-1302
Phone: 8508838227

KAYLE ELIZABETH SOUTHERLAND (NPI# 1376186213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376186213
Entity Type Individual
Full Name KAYLE ELIZABETH SOUTHERLAND
Credential IDMT, USAF
Practice Address 307 Boatner Rd
Eglin Afb
FL 32542-1302
Practice Telephone 8508838227
Enumeration Date 2019-10-23
Last Update Date 2019-10-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 307 BOATNER RD
City EGLIN AFB
State FL
Zip Code 32542-1302

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083618987 Clarence E Pearson Internal Medicine 307 Boatner Rd, Suite 114, Eglin Afb, FL 32542-1302 2005-06-08
1821600024 David George Morrison Jr. Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2020-08-19
1679185250 Peter Andrew Watters Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2020-08-17
1558981365 Kassandra Martinez-campos Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2020-04-22
1023638830 Chanute Lockhart Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2020-04-22
1801434964 Bryan Meek Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2019-12-19
1710525936 Kaitlin Dickson Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2019-12-18
1902452063 Justin Michael Rhoads Pharmacist 307 Boatner Rd, Eglin Afb, FL 32542-1302 2019-08-14
1295389609 Joseph Clarence Smith Jr. Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542 2019-07-25
1568015105 Kylie Hamilton Physician Assistant 307 Boatner Rd, Eglin Afb, FL 32542-1302 2019-07-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417440306 Colt Sicher Student in an Organized Health Care Education/Training Program 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 2018-06-14
1841679529 Matthew Scurria Dentist 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 2015-05-27
1134518798 96th Medical Support Squadron Military/U.S. Coast Guard Pharmacy 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 2015-01-20
1598177123 96th Medical Support Squadron Military/U.S. Coast Guard Pharmacy 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 2014-06-02
1548602923 Gerald Jordan Novack Psychologist 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 2013-07-25
1699112821 Taylor Anne Hahn Obstetrics & Gynecology 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 2013-05-29
1730456948 Nicholas Brandon Sager Dentist 340 Boatner Rd, Eglin Afb, Apo, AA 32542 2011-11-17
1134402662 Jessamy Jae Thornton Student in an Organized Health Care Education/Training Program 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 2011-09-21
1346523974 Mary Elizabeth Sorrentino Dentist 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 2011-09-20
1588945612 Martin Army Community Hospital Clinic/Center 4327 North El Salvador Way, Eglin Afb, FL 32542 2011-09-02
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730491176 Travis J Fritz Military Health Care Provider 712 Osceola Cir, Eglin Afb, FL 32542-1638 2010-07-13
1760625974 Dexter Eli Vanderpool Military Health Care Provider 101 Griffin Way, Eglin Afb, FL 32542 2009-04-17
1366042178 Whitney Nichole Eckstine Military Health Care Provider 340 Boatner Rd, Eglin Afb, FL 32542-1391 2020-10-30
1336774215 Emanuel Leroy Lookadoo Jr. Military Health Care Provider 340 Boatner Rd, Eglin Afb, FL 32542-1391 2020-03-11
1669012555 Jeremy Carmical Military Health Care Provider 340 Boatner Rd, Eglin Afb, FL 32542-1391 2020-01-09
1033671227 Stephen Thomas Biggs Military Health Care Provider 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 2019-04-05
1053870428 Albert Roy Schliesleder Jr. Military Health Care Provider 307 Boatner Rd, Eglin Afb, FL 32542-1302 2019-03-15
1245701473 Marc Anthony Marrero Military Health Care Provider 307 Boatner Rd, Eglin Afb, FL 32542-1302 2018-12-16
1053814236 Kirsty Lynn House Military Health Care Provider 307 Boatner Rd, Eglin Afb, FL 32542-1302 2018-03-14
1245756055 James B Raper Military Health Care Provider 307 Boatner Rd, Eglin Afb, FL 32542-1302 2017-08-15
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Competitor

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City EGLIN AFB
Zip Code 32542

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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