Individual
KIMBALL STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2014 STRATFORD RD, LAWRENCE, KS 66044-4542
(785) 842-1607
Mailing address
2014 STRATFORD RD, LAWRENCE, KS 66044-4542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-19882
KS
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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