Search › Idaho › 363AS0400X
Kyle Havercroft, PA-C
NPI 1700063344 · on the registry since 2008
Practice
- Address
- 850 W Ironwood Dr Ste 202
Coeur D Alene, ID 83814 - Phone
- (208) 664-2175
- Fax
- (208) 664-1226
- Organisation at this address
- Nwaic, Llc
Joyce Kelley Lmt
Asc Northwest Llc
Avanti Health Llc
Premier Spine PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 55
Additional practice sites
- 1651 E Polston Ave, Post Falls, ID
Registry record
- Primary taxonomy
- 363AS0400X
363AS0400X
- Also registered as
- 363A00000X
363AM0700X - Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-08-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho