Individual
DR. KODY BLAKE FINSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
940 W MOUNT VERNON ST STE 220, NIXA, MO 65714
(417) 724-5437
(417) 724-5433
Mailing address
940 W MOUNT VERNON ST STE 220, NIXA, MO 65714-9613
(417) 724-5437
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2007015054
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932396777
—
MO
Enumeration date
09/25/2007
Last updated
07/02/2018
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