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Individual

MARY STUPPY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2817 SAINT JOHNS BLVD, JOPLIN, MO 64804-1563
(417) 781-2727
(417) 625-2279
Mailing address
2817 SAINT JOHNS BLVD, JOPLIN, MO 64804-1563
(417) 781-2727
(417) 625-2279

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
102912
MO
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
102912
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
102912
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100182790B
OK
05
100368050E
KS
05
208646123
MO
Enumeration date
03/02/2006
Last updated
02/10/2012
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