Individual
KIRK LESLIE SCOFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3580 ARCADE ST, VADNAIS HEIGHTS, MN 55127-7135
(651) 968-5770
(651) 968-5775
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5042
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4381
AK
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
54590
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD4391
—
AK
Enumeration date
01/25/2006
Last updated
07/02/2015
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