Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kyle Phillip Radack, MD

Individual provider Dermatology Physician · NPI 1154663672

Dr. Kyle Phillip Radack, MD is a Dermatology in Kingsport, Tennessee. Graduated from Medical University of South Carolina College of Medicine in 2013, 13 years ago. Practices with Dermatology Associates, PC, a 26-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
13
Trained at
Medical University of South Carolina College of Medicine
Licensed in
TN
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone: (423) 246-4961
Fax: (423) 245-3136
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence MD56094 (TN)

Record details

NPI number1154663672
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2013
Last updated in NPPESFebruary 23, 2018
Mailing address2300 W Stone Dr, Kingsport, TN 37660-2360

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Dermatology Associates, P.C. — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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