Individual
KEVIN MICHEL MIDDLEMIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-8000
(573) 556-1710
Mailing address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-8000
(573) 556-1710
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2022031059
MO
Other
Enumeration date
03/16/2016
Last updated
06/28/2023
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