Individual
STANLEY K DORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 634-7423
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 634-7423
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000168795
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC7852
RR GROUP
MO
01
—
P00384875
RAILROAD MEDICARE
MO
Enumeration date
05/01/2006
Last updated
11/09/2007
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