Individual
DR. KIMBERLY M CREACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2055 S FREMONT AVE, SPRINGFIELD, MO 65804-2206
(417) 820-2468
(417) 820-7794
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2007018077
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558568618
—
MO
05
—
193950001
—
AR
01
—
431560263
TRICARE
MO
01
—
P01089901
RR MCR
MO
Enumeration date
06/29/2007
Last updated
10/02/2014
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