1194719849 NPI number — DR. KIM MCCURRY STOAKES PHARMD, MS HCA, BCPS

Table of content: DR. KIM MCCURRY STOAKES PHARMD, MS HCA, BCPS (NPI 1194719849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194719849 NPI number — DR. KIM MCCURRY STOAKES PHARMD, MS HCA, BCPS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOAKES
Provider First Name:
KIM
Provider Middle Name:
MCCURRY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD, MS HCA, BCPS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194719849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1340 STEINER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-297-2417
Provider Business Mailing Address Fax Number:
515-832-3550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 KENYON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT DODGE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-574-6696
Provider Business Practice Location Address Fax Number:
515-832-4083
Provider Enumeration Date:
09/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  16866 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com