Individual
STEPHEN R BERKSTRESSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
343 YANDELL COVE RD, KIRBYVILLE, MO 65679-8387
(417) 546-5572
Mailing address
343 YANDELL COVE RD, KIRBYVILLE, MO 65679-8387
(417) 546-5572
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102310
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080110697
RAILROAD MEDICARE
—
05
—
220082007
—
MO
05
—
507954006
—
MO
01
—
8068
BCBS
—
Enumeration date
09/20/2006
Last updated
05/26/2021
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