Individual
DR. KIMBERLY D. STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2115 S FREMONT AVE, SUITE 2900, SPRINGFIELD, MO 65804-2239
(417) 820-3535
(417) 820-3540
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2012014201
MO
208000000X
Pediatrics Physician
34394
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124137252
—
MO
05
—
2247346
—
IA
01
—
32018
WELLMARK BLUE SHIELD
IA
05
—
3247346
—
IA
Enumeration date
08/30/2006
Last updated
11/27/2012
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