| Kirkwood Diagnostic & Orthopedic Associates, Llc. | |
|
333 S Kirkwood Rd Suite 203 Saint Louis MO 63122-6161 | |
| (314) 909-1666 | |
| (314) 909-7406 |
| Full Name | Kirkwood Diagnostic & Orthopedic Associates, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 333 S Kirkwood Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Dave Horace (BUSINESS MANAGER) |
| Authorized Official Contact | 3149091666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kirkwood Diagnostic & Orthopedic Associates, Llc. 333 S Kirkwood Rd Suite 203 Saint Louis MO 63122-6161 Ph: (314) 909-1666 | Kirkwood Diagnostic & Orthopedic Associates, Llc. 333 S Kirkwood Rd Suite 203 Saint Louis MO 63122-6161 Ph: (314) 909-1666 |
| NPI Number | 1295839702 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3476526484 |
|---|---|
| Medicare Enrollment ID | O20040818000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295839702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 109216 (Missouri) | Primary |
| Provider Name | Steven D Stahle |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1578672341 PECOS PAC ID: 1850498585 Enrollment ID: I20101015000943 |
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