MEDICARE: KEVIN K STILES MD

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
1	207Q00000X	Family Medicine Physician	34689	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0128557	OTHER	MN	MEDICA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2T846ST	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1134203706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN K STILES MD

Provider Business Mailing Address
First Line	:	471 HIGHWAY 23
Second Line	:	FOLEY MEDICAL CENTER
City	:	FOLEY
State	:	MN
Zip	:	56329-0218
Country	:	US
Telephone Number	:	320-968-7234
Fax Number	:	320-968-7237

Provider Business Practice Location Address
First Line	:	471 HIGHWAY 23
Second Line	:	FOLEY MEDICAL CENTER
City	:	FOLEY
State	:	MN
Zip	:	56329-0218
Country	:	US
Telephone Number	:	320-968-7234
Fax Number	:	320-968-7237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	05/26/2015

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