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NPI Code Detail

MEDICARE: DR. KRISTIE LEE MARBLE D.O.

MEDICARE: DR. KRISTIE LEE MARBLE D.O.
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 Physician2012028973MO
2208000000XPediatrics Physician05-35929KS

General Provider Information

NPI Number : 1396975298
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIE LEE MARBLE D.O.
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line : PROVIDER ENROLLMENT DEPT
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-701-5200
Fax Number : 816-302-9939
Provider Business Practice Location Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3000
Fax Number : 816-302-9939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2009
Last Update Date : 05/26/2026

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