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NPI Code Detail

MEDICARE: KIMBER GUINN DO

MEDICARE: KIMBER GUINN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2019015005MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12019015005OTHERMOSTATE LICENSE

General Provider Information

NPI Number : 1962853986
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBER GUINN DO
Provider Business Mailing Address
First Line : 400 N KEENE ST
Second Line : SOUTH PAVILION
City : COLUMBIA
State : MO
Zip : 65201-6626
Country : US
Telephone Number : 573-882-4438
Fax Number : 583-884-9992
Provider Business Practice Location Address
First Line : 54 HOSPITAL DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3050
Country : US
Telephone Number : 573-348-8000
Fax Number : 573-302-2241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2016
Last Update Date : 12/31/2025

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Directions to “ KIMBER GUINN DO” Practice Location

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