Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Kyle L Koski, PA-C

Individual provider Medical Physician Assistant · NPI 1407803588

Mr. Kyle L Koski, PA-C is a Medical Physician Assistant in Phoenix, Arizona. Works from 3 locations. Licensed in Arizona and Oregon.

Licensed in
AZ, OR
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11034 N 23rd Dr # 105B
Phoenix, AZ 85029-4743
Phone: (602) 639-0189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 165 El Camino Real, Sierra Vista, AZ 85635 — (520) 458-1787
  • 1793 13th St Se, Salem, OR 97302-2541 — (503) 362-8385

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 3392 (AZ)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA1865293 (OR)

Record details

NPI number1407803588
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 27, 2006
Last updated in NPPESFebruary 5, 2020
Certification dateFebruary 5, 2020

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