Individual
MICHAEL KINKADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1605 E BROADWAY STE 110, COLUMBIA, MO 65201-8023
(573) 815-8130
(573) 815-8149
Mailing address
1605 E BROADWAY STE 110, COLUMBIA, MO 65201-8023
(573) 815-8130
(573) 815-8149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003002314
MO
Other
Enumeration date
08/30/2006
Last updated
10/25/2021
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