Individual
DR. KENNETH R BRIGHTFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12855 N 40 DR, SAINT LOUIS, MO 63141-8657
(314) 432-4415
(314) 432-1986
Mailing address
12855 N 40 DR, SUITE 280, ST. LOUIS, MO 63141
(314) 432-4415
(314) 432-1986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R5C32
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00616024
RAILROAD MEDICARE
—
01
—
P01134545
RAILROAD MEDICARE
MO
Enumeration date
07/18/2006
Last updated
09/19/2014
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