Individual
KERRY E FLORENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(636) 327-1100
Mailing address
PO BOX 790129, DEPT EC, SAINT LOUIS, MO 63179-0129
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36079
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196690
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/16/2005
Last updated
08/07/2007
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