Individual
KIMBELL KORNU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-8462
Mailing address
1008 S SPRING AVE FL 2, SAINT LOUIS, MO 63110-2520
(314) 977-8462
(314) 977-3370
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD0000047954
TN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
2015012454
MO
Other
Enumeration date
04/14/2009
Last updated
03/12/2021
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