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

Kyle Maxum

Individual provider Physician Assistant · NPI 1225805211

Kyle Maxum is a Physician Assistant in Fort Defiance, Arizona. Licensed in Colorado. Registered with an NPI since 2023.

Licensed in
CO
In the registry since
2023
Specialties on file
2

Practice location Address checks out

Corner Of Route N12 And N7
Fort Defiance, AZ 86504
Phone: (928) 729-8000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0008848 (CO)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1225805211
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 8, 2023
Last updated in NPPESNovember 12, 2024
Certification dateNovember 8, 2024
Mailing addressPo Box 649, Fort Defiance, AZ 86504-0649

Other providers in Fort Defiance