Healthcare Provider Details

I. General information

NPI: 1679530679
Provider Name (Legal Business Name): STEPHANIE D BAGBY-STONE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 08/16/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HOSPITAL DR
COLUMBIA MO
65201-5276
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-2511
  • Fax: 573-884-1070
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2003007032
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: